植入式静脉输液港相关并发症的护理对策

Nursing of related complications of implanted venous port

目的：探索植入式静脉输液港使用中的并发症，分析其原因，并寻找预防措施。方法收集2013年11月—2015年11月在吉林大学中日联谊医院新民院区普外科植入静脉输液港的102例患者临床资料，记录2周内护理和维护期护理记录，总结常见的并发症，分析其产生的可能原因，探索制订可行的护理对策。结果102例患者随访时间为7-31个月，中位随访时间为19个月，在住院护理和出院维护期间，并发症发生率分别为37.25%（38/102）、10.89%（11/101），两个时间段并发症发生率差异有统计学意义（ P〈0.05）。其中，常见并发症包括颈部及患肢肿胀、切口并发症和导液管堵塞。结论输液港植入术后2周内的并发症明显高于维护期，其中导管相关性血栓形成、底座损坏、导管异位属于严重并发症，直接影响输液港的使用寿命；护理输液港过程中严格遵守输液港操作规程，在置管前、中、后做好有效的健康宣教，使患者及家属了解并掌握输液港相关的护理知识，可降低并发症的发生率，保证输液港的安全使用。

Objective To explore the complications in the nursing work of implanted venous portand its causes, so as to explore the preventive methods. Methods We collected the clinical data and the nursing data of 102 patients with implanted venous port in our department from November 2013 to November 2015. Nursing records during the maintain period were recorded, common complications were summarized, the reasons were analyzed, and nursing interventions were explored and made. Results Among 102 patients, the following-up time was 7-31 months, and the median follow-up time was 19 months. There were 38 cases （ 37. 25%） of complications occurred 2 weeks after operation and 11 cases （ 10. 89%） of complications occurred during discharge maintenance, the difference was statistically significant （ P〈0. 05 ） . The common complications included the sweeling of neck and limps, incision complication and blochage in catheter. Conclusions The incidence of complications within 2 weeks after implanting surgery is higher than that during the maintain period. Among all the complications, catheter associated thrombosis, damaged base and ectopic catheter are the most serious and they can cause the discontinue use of port. By following the recommended operating procedures during the implementation of nursing work, bettering the health education, and improving the patients′understanding of implanted venous port, we can reduce the incidence rate of complications, and ensure the safety use of venous port.