巴德耐高压型导管在肿瘤患者外周静脉穿刺置入中心静脉导管术中的应用及置管部位并发症的护理

Badne Highpressuretype Catheters use for Peripherally Inserted Central Catheterin Tumor Patients and Position and Nursing of Catheters Complication

目的探讨巴德耐高压型导管在肿瘤患者外周静脉穿刺置入中心静脉导管(PICC)术中的应用,分析置管部位(上及下肘)并发症及护理对策。方法选取我科室2016年4月至2016年6月期间PICC置管的恶性肿瘤患者30例,根据PICC导管置入的穿刺部位分为上臂置管组15例和肘下置管组15例;均行PICC导管置入治疗。结果上臂置管组、肘下置管组置管成功率均为100%,但上臂置管组并发症发生率13.33%显著低于肘下置管组46.67%(7/15)。上臂置管组舒适度评分(6.94±1.92)分、Karnofsky评分(76.53±5.13)分均显著高于肘下置管组(P<0.01)。结论巴德耐高压型PICC导管在肿瘤患者中应用价值高,PICC导管的穿刺部位以上臂置入为佳,肘下导管置入期间易发生堵管、血栓性静脉炎等并发症,因此应采取高压团注后的护理、集束化护理、并发症预防护理等护理措施进行相关对症干预。

Objective To explore application of Badne high pressure type for peripherally inserted central catheter（PICC） catheters in tumor patients, to analyze position of catheters （ upper and lower elbows） complication and nursing. Methods 30 patients with malignancy in our hospital from April 2016 to July 2016 who underwent PICC catheter were selected,they were divided into the upper arm catheter group（ 15 cases） and below elbow catheter group（ 15 cases）according to site of puncture of PICC catheter insertion;all patients underwent PICC catheter insertion treatment. Results Success rate of catheter in the two group were 100%, but complication rate in the upper arm catheter group 13.33% was significantly lower than below elbow catheter group （46. 67% ） （P 〈 0. 05 ）. Scores in comfort（6.94 ± 1.92 ）score, Karnofsky score （76. 53 ± 5.13 ） score in the upper arm catheter group were significantly higher than below elbow catheter group（P 〈0. 01 ）. Conclusion Application value of Badne high pressure type PICC catheters in tumor patients is high, the upper arm is the better site of puncture of PICC catheter, plugging, thrombophlebitis and other complications are easily occurred during catheter insertion, so nursing after high pressure bolus injection, cluster nursing, complication prevention and nursing and other nursing interventions should be used to do related symptomatic intervention.