腹膜透析导管体外破损原因分析及护理对策

Reasons and nursing strategies of damaged peritoneal dialysis catheter outside the body

2007年1月至2015年12月行腹膜透析的808例患者中有13例发生腹膜透析导管体外部分破损,破损后发生腹膜炎10例,其中3例因腹膜炎终止透析。分析原因可能有:导管某部位长期折叠牵拉,患者及家属知识缺乏使用剪刀剪断,锐器意外刺破导管。经临床观察总结,提出加强患者及家属的健康教育、制订腹膜透析导管意外处理流程、加强院外电话随访的护理对策,以提高患者的自我护理能力。

Among 808 patients with peritoneal dialysis from January 2007 to December 2015,thirteen cases got their dialysis catheter outside damaged and the incidence was 1.60%. Ten patients had peritonitis after the catheter broken and three cases stopped peritoneal dialysis because of peritonitis. The possible reasons were the catheter was folded and pulled for a long time,patients who lack of knowledge pierced the catheter by using scissors. Nursing strategies we proposed included education and training for patients and family members ,development of accident peritoneal dialysis catheter process,telephone follow-up,improvement of nurses＇ awareness of complications and emergency response.