IABP患者实施管道护理预防非计划性拔管的探讨

Study of canal nursing implemented on prevention of nonplanned decannulation in patients with IABP

目的探讨使用主动脉内球囊反搏（IABP）的患者管道护理,预防非计划性拔管的发生。方法对比我科2010~2013年间使用IABP患者的管道护理结果：2010年1月~2011年12月,对照组共有42例患者,年龄38~81岁,使用IABP时间48~384h,其中发生3例非计划性拔管;通过原因分析,找出管道护理及肢体约束等存在的问题,采取相应的护理措施后,2012年1月~2013年12月,实验组共有46例患者,年龄41~78岁,使用IABP时间24~336h,没有非计划性拔管的发生。结果对照组42例患者使用IABP时间48~384h,平均（163.45±27.26）h,发生非计划性拔管6例,事故率7.79%。研究组46例患者使用IABP时间24~336h,平均（168.73±31.52）h,无非计划性拔管病例,事故率0。两组应用IABP时间无显著差异（P〉0.05）,但两组事故率有显著差异（P〈0.05）。结论完善约束处置及规范主动脉球囊反搏导管的固定能明显减少使用主动脉球囊反搏患者非计划性拔管的发生。

Objective To study the implementation of canal nursing in patients with intra-aortic balloon pump（IABP）, to prevent the occurrence of non-planned decannulation. Methods To compare the results of canal nursing in patients with IABP from 2010 to 2013. 42 patients with IABP and 38-81 years old, who were selected as the control group from January 2010 to December 2011, were used with IABP from 48h to 384h, with 3 cases non-planned decannulation. Through the analysis of cause, to find out the problem of canal nursing and limb-restraint and so on, to adopt corresponding nursing measures. While 46 patients with IABP and 41-78 years old, who were selected as the experimental group from January 2012 to December 2013, were were used with IABP from 24h to 336h, without non-planned decannulation. Results The average using time was（163.45±27.26）h, the accident rate was 7.79%with 6 cases non-planned decannulation in control group, while the using time was（168.73±31.52）h without non-planned decannulation and accident in experimental group, the differences of the using time of IABP between the two groups was no statistical significance（P〉0.05）, but the differences of the accident rate between the two groups was statically significant（P 〈 0.05）. Conclusion Perfect restrained disposition and normative immobilization of IABP catheter could obviously reduce the occurrence of non-planned decannulation.