城乡联合延续护理对耐多药肺结核患者带PICC出院后强化治疗的影响

The influence of urban-rural united and continuous care on the intensive treatment of multi-drug-resistant pulmonary tuberculosis patients inserted with PICC

目的 总结耐多药肺结核患者出院后长期携带PICC城乡联合延续护理的效果.方法 对32例出院后长期应用PICC进行规范治疗的耐多药肺结核患者实施城乡联合延续性护理.住院期间植入PICC,出院前对患者居住地的乡村医生进行PICC应用培训.患者痰菌转阴性后携带PICC出院,由乡村医生完成每日输液,本院护士每周家访2次维护导管和督使患者用药.在强化治疗3、6、9个月时,评价PICC导管应用和强化治疗完成情况.结果 32例患者中1例失访,1例因肝肾功能衰竭被迫停药拔管,应用PICC强化期治疗完成率93.8%;在随访过程中,护患关系和谐,护理满意度达到100%,为完成全程规范治疗奠定了良好的基础.结论 城乡联合延续护理能提高PICC长期使用率和耐多药肺结核强化期治疗的完成率,值得推广.

Objective To summarize the effect of urban-rural united and continuous care on the intensive treatment of multi-drug-resistant pulmonary tuberculosis patients inserted with PICC. Methods A total of 32 multi-drug-resistant pulmonary tuberculosis patients who applied PICC for standardized treatment for a long term after discharge were given the urban-rural united and continuous care and PICC was implanted during their hospitalization. The rural doctors of the patientsˊresidence were given PICC application training before their discharge. The patients were discharged in-serted with PICC when the sputum bacterium turned negative and the daily infusion was finished by the rural doctors. The nurses made the follow-up visit twice a week to maintain the catheters and to supervise drug use. The application of PICC and the completion of intensive treatment were evaluated after 3, 6 and 9 monthsˊintensive treatment. Results Among the 32 cases of patients, 1 case was lost for the follow-up visit and 1 case was forced to withdraw the tube be-cause of the exhaustion of the kidney function. The completion rate during the intensive-treatment period with the appli-cation of PICC was 93. 8%. The relationship between nurses and patients was harmonious in the process of follow-up and the satisfaction rate for nursing reached 100%, which lay a sound foundation for the completion of the entire stand-ardized treatment. Conclusions Urban-rural united and continuous care can improve the long-term usage of PICC and enhance the completion rate of intensive treatment of the multi-drug-resistant tuberculosis, hence it is worth promoting.