经外周置入中心静脉导管肺癌患者穿刺点出血的护理

Study of nursing of puncture point bleeding of lung cancer patients with PICC

目的探讨肺癌患者接受经外周置入中心静脉导管(PICC)后出现穿刺点出血的护理措施。方法回顾性分析56例接受化疗的临床行PICC置管的肺癌患者的临床资料,总结出现穿刺点出血的原因并制定相应护理对策。结果 56例PICC置管患者中,50例患者置管为1次成功,其中有11例患者出现置管后穿刺点出血情况,经护理后,出血停止且无需重新置管。本组患者对护理服务态度评分为(91.25±1.12)分、对护理操作能力评分为(89.54±2.45)分、护患交流为(90.14±1.41)分、健康宣教为(90.31±2.56)分,对护理治疗的满意评分普遍较高。结论针对肺癌患者PICC置管穿刺点出血情况,护理人员应及时清除渗出液及血液,更换无菌敷料,重新加压止血,妥善固定24 h后再次查看穿刺点部位情况,一般经及时处理后不影响导管使用。

Objective To study the nursing measures of puncture point bleeding of lung cancer patients with PICC. Methods Clinical data of 56 lung cancer patients with PICC in our hos- pital was retrospective analyzed, causes of bleeding of puncture point was summarized and corre- sponding nursing countermeasures were implemented. Results Out of 56 patients with PICC, 50 pa- tients were successfully catheterized, there were 11 patients with puncture point bleeding after cathe- ter, but bleeding was stopped and there was no re-catheterization after nursing. Scores of nursing service attitude were （91.25± 1.12） points, scores of nursing operation ability was （89.54 ± 2.45 ） points, nurse-patient communication score was （90.14 ± 1.41 ） points, health education score was （90.31 ± 2.56） points. And patients were generally satisfied with nursing. Conclusion Nursing staff should remove puncture point bleeding, exudates and blood for patients, replace sterile dressing, and repeat pressure and hemostasis. Situation of the puncture site are viewed again after 24 hours of properly fixing, and catheter is not affected after timely treatment.