优质护理干预对经外周静脉置入中心静脉导管置管肿瘤患者的影响

Effect of high quality nursing intervention on tumor patients treated by PICC catheterization

目的探讨优质护理应用于经外周静脉置入中心静脉导管（PICC）置管肿瘤患者对于改善患者心理健康状况、提高依从性和满意度的应用价值。方法选取2014年1~12月接受PICC置管的肿瘤患者160例,分为研究组和对照组各80例,对照组采用基础护理,研究组采用优质护理,比较两组患者心理状况评分、依从性、满意度和并发症发生情况。结果研究组患者症状自评量表9个维度（焦虑、抑郁、精神、偏执、强迫、恐怖、敏感、敌对和躯体化）评分分别为（1.3±0.2）、（1.4±0.2）、（1.4±0.3）、（1.3±0.2）、（1.4±0.2）、（1.2±0.2）、（1.4±0.2）、（1.2±0.3）、（1.3±0.2）分;对照组分别为（1.8±0.2）、（1.9±0.3）、（1.7±0.3）、（1.8±0.3）、（1.8±0.2）、（1.7±0.2）、（1.9±0.3）、（1.6±0.2）、（1.7±0.3）分,两组比较差异有统计学意义（t=15.811、12.404、6.325、12.404、12.649、15.811、12.404、9.923、9.923,P〈0.05）。研究组患者依从性（90.0%）和满意度（95.0%）显著高于对照组的52.5%和56.3%,差异有统计学意义（χ2=27.460、32.583,P〈0.05）。研究组患者穿刺点红肿、导管渗液、导管相关性血流感染、机械性静脉炎和非计划拔管率分别为7.5%、2.5%、5.0%、7.5%、5.0%;对照组为20.0%、12.5%、20.0%、20.0%、17.5%,两组比较差异有统计学意义（χ2=5.270、5.766、8.229、5.270、6.260,P〈0.05）。结论优质护理用于PICC置管患者的临床护理具有良好的效果,对改善患者心理状况、提高依从性和降低并发症发生率作用明显,患者满意度高。

Objective To investigate the application value of high quality nursing service for the improvement of mental health,compliance and satisfaction of tumor patients treated by PICC catheterization.Methods 160 cases of tumor patients treated by PICC catheterization were selected from January 2014 to December 2014,and divided into study group and control group,with 80 cases in each group.Patients in control group and study group were treated by basic nursing and high quality nursing,respectively.The mental status scores,compliance,satisfaction and the incidences of complications of two groups were compared.Results The scores of 9dimensions of SCL-90,including anxiety,depression,spirit,paranoia,compulsion,terror,sensitivity,hostility and somatic,respectively were 1.3±0.2,1.4±0.2,1.4±0.3,1.3±0.2,1.4±0.2,1.2±0.2,1.4±0.2,1.2±0.3,and 1.3±0.2in study group,which in control group were 1.8±0.2,1.9±0.3,1.7±0.3,1.8±0.3,1.8±0.2,1.7±0.2,1.9±0.3,1.6±0.2,1.7±0.3,respectively.The differences of the scores between two groups were statistically significant（t=15.811,12.404,6.325,12.404,12.649,15.811,12.404,9.923,9.923,P〈0.05）.The compliance and satisfaction of study group were 90.0% and 95.0%,respectively,which were significantly higher than those of control group（52.5% and56.3%,respectively）,with statistical difference（χ2=27.460,32.583,P〈0.05）.The incidences of puncture site redness,catheter leakage,catheter-related bloodstream infections,mechanical phlebitis,and non-planning extubation in study group were 7.5%,2.5%,5.0%,7.5%,and 5.0%,respectively,which were 20.0%,12.5%,20.0%,20.0%,17.5% respectively in control group,with statistical difference（χ2=5.270,5.766,8.229,5.270,6.260,P〈0.05）.Conclusion The quality nursing care showed a good effect on the improvement of mental health and compliance,and the reduction of complication incidence in the patients treated by PICC catheterization,which had high patient satisfaction.