质量改进在防治PICC相关性上肢静脉血栓中的应用

Effect of Quality Improvement in Prevention of PICC-Related Upper Extremity Venous Thrombosis

目的探讨质量改进在防治PICC相关性上肢静脉血栓中的应用。方法2013-02—2013-10月行PICC置管的98例肺癌患者为对照组,2013-12—2014-08月行PICC置管的104例肺癌患者为干预组。PICC专业委员会成员收集、分析对照组发生PICC相关性上肢静脉血栓患者的病历资料,遵循循证医学理念,总结、归纳出导管相关性上肢静脉血栓的临床表现、诊断方法、治疗方法和干预措施。组织相关科室护理人员培训考核后,对干预组加以干预。结果对照组98例,发生导管相关性上肢静脉血栓9例,发生率9.18%,治愈率55.6%;干预组104例,发生导管相关性上肢静脉血栓2例,发生率1.92%,治愈率100%。结论科学规范的质量改进措施减少了PICC导管相关性上肢静脉血栓的发生率,提高了治愈率。

Objective To discuss the effect of quality improvement in prevention of PICC-related upper extremity venous thrombosis. Methods From February to October 2013 in Thoracic Surgery Department and Medical Oncology Department of First Affiliated Hospital of Hebei North University, 98 cases of lung cancer patients with PICCcatheterization were collected as the control group and 104 cases from December 2013 to August 2014 as the intervention group. The PICCspecial committee collected and analyzed the medical records of the control group about PICC-related upper extremity venous thrombosis and worked out the clinical manifestations, diagnostic methods, treatment methods and intervention measures by evidence-based medicine. The nursing staff in related departments intervened the patients after training and examination. Results 9 of 98 （9.18%） cases of patients in the control group were found to suffer from catheter-related upper extremity venous thrombosis and the curative rate was 55.6%. 2 of 104 （1.92%） cases of patients in the intervention group had catheter-related upper extremity venous thrombosis and the curative rate was 100%. Conclusion The normative and scientific quality improvement of PICC special organization can reduce the incidence of PICC catheter-related venous thrombosis greatly and improve the curative rate.