PICC相关血栓形成的原因及PDCA循环护理效果分析

PICC thrombosis related to the cause and the PDCA circulation nursing effect analysis

目的探讨经外周静脉置入的中心静脉导管（PICC）相关血栓形成的原因及PDCA循环护理效果。方法选取2014年1月～2015年10月于海军总医院接受治疗的200例PICC置管术患者为研究对象，按照随机原则，将其均分为观察组和对照组。对照组采用常规护理方式进行护理；观察组采用PI）CA循环护理。分析PICC相关血俭形成的原因，比较两组患者PICC相关血栓及其他不良并发症情况及住院时间和置管时间。结果护士护理质量不达标、安全意识小高、疾病类型、PICC导管异位、护士置管过程不规范、与患者的沟通不良是引起血栓的重要原因。规察组血栓、静脉炎、感染、导管堵塞、导管脱出断裂、过敏的比例分别为2％、0、1％、3％、1％、2％；观察组血栓及其他不良并发症明显少于对照组（P〈0．05）。观察组住院时间为（15．2±4．7）d，置管时间1d以下、1～2d、3～4d、4d以上分别有7、37、48、8例；对照组分别为（25．3±8．6）d、31例、59例、4例、6例，观察组置管时间和住院时间明显短于对照组（P〈0．05）。结论护士护理质量不达标及安全意以不高、疾病类型等是引起血栓的重要原因。PDCA循环护理能有效降低血栓发生率，缩短置管时间和治疗时间，临床效果显著。

Objective To explore the eause of the usm thrombosis and the nursing effect of PDCA cycle. Methods 200 patients with PICC catheter technique from Janual7 2014 to October 2015 in our hospital for treatment were selected as the research object, according to the principle of random, divided them into observation group and control group. The control group used conventional care Nursing, observation group used PDCA cycle. Analysed the reason of usm related thrombosis, compared two groups of patients with PICC related thrombosis and other adverse complications and length of hospital stay and the time of insertion. Results nurses nursing quality standards, safety awareness is not high, the types of diseases, PICC catheter heterotopia, nurse insertion process is not standard, poor communication with patients were important causes of blood clots. 1.00%, 0%, 1.00%, 3.00%, 1.00%, 2.00% in the observation group, blood clots and other adverse complications observed group were obviously less than control group （P 〈 0.05）. Observation group length of hospital stayed （15.2±4.7） d, the time of insertion, 1 - 2 day, under 1 day , 3 - 4 day ,more than 4 day, there were 7 cases, 37 cases, 48 cases, 8 cases; The control group, respectively were（25.3±8.6） d, 31 cases, 59 cases, 4 cases, 6 cases, catheter time and hospitalization time observation group were obviously shorter than the control group （P 〈 0.05）. Conclusion The nurses nursing quality standard and safety consciousness, the types of diseases are the important causes of blood clots. PDCA circulation nursing can effectively reduce the incidence of thrombosis, shortening the time of catheter and treatment time, clinical effect is remarkable.