经外周静脉置入中心静脉导管维护标准化流程对护理质量及导管相关性并发症的影响

Effect of peripherally inserted central catheter catheter maintenance standardized processes on care quality and catheter-related complications

目的探讨经外周静脉置入中心静脉导管（PICC）维护标准化流程对护理质量及导管相关性并发症的影响。方法选择2014年5月~2015年3月在我院肿瘤科住院治疗的PICC置管患者204例,将其随机分为对照组（100例）和实验组（104例）。对照组采用肿瘤科常规导管维护方法,实验组严格按照PICC导管维护标准流程实施导管维护,比较两组护理人员的护理质量及导管相关并发症（静脉炎、导管相关性感染、导管相关性血栓、堵管、导管脱出等）的发生率。结果两组护理人员的护理质量：实验组和对照组置管所需时间[（16.97±6.53）vs（27.86±4.55）min]比较,差异有统计学意义（t=7.52,P〈0.05）,PICC留置时间[（115.24±43.59）vs（101.85±20.24）d]比较,差异有统计学意义（t=10.75,P〈0.05）。并发症发生情况：实验组静脉炎发生率（2.88%）低于对照组（11.00%）（χ~2=5.00,P〈0.05）,导管相关性感染发生率（1.92%）低于对照组（9.00%）（χ~2=5.00,P〈0.05）,堵管发生率（3.85%）低于对照组（13.00%）（χ~2=5.60,P〈0.05）;两组导管脱出、导管相关性血栓的发生率差异无统计学意义（P〉0.05）。结论实施PICC导管维护标准流程可以规范护士导管维护的操作规程,提高护理质量,有效控制导管相关性并发症,对保障患者的静脉治疗安全起到积极的作用。

Objective To explore the effect of peripherally inserted central catheter（PICC）catheter maintenance standardized processes on care quality and catheter-related complications.Methods 204 cases of hospitalized patients with PICC in department of oncology of our hospital from May 2014 to March 2015 were selected and randomly divided into control group（100 cases）and experiment group（104 cases）.The control group was given conventional catheter maintenance methods,the experiment group was strictly given the standard procedure of PICC implementation catheter maintenance.The care quality and the incidence of complications（phlebitis,catheter-related infections,catheter-related blood clots,blocked tubes,catheters prolapse,etc.）in two groups was compared.Results Care quality of the nurses was compared：there was a significant difference about the required catheterization time in experiment group and control group [16.97±6.53）min vs（27.86±4.55）min]（t=7.52,P0.05）,there was a significant difference about PICC average retention time[（115.24±43.59）d vs（101.85±20.24）d]（t=10.75,P0.05）.The incidences of the complications was compared：phlebitis rate in the experiment group（2.88%）was lower than that of control group（11.00%）（χ~2=5.25,P0.05）,catheter-related infection rate in experiment group（1.92%）was lower than that of control group（9.00%）（χ~2=5.00,P0.05）,the incidence of plugging in experiment group（3.85%）was lower than that of control group（13.00%）（χ~2=5.60,P0.05）,but there was no significant difference（P 0.05）of incidence of catheter-related thrombosis and catheter prolapse in two groups.Conclusion The implementation of the PICC catheter maintain standard processes could make catheter maintenance procedures standardize for the nurses,and could improve quality of care,effectively control catheter-related complications,it plays an active role on safeguards for intravenous treatment of patients.