海藻盐敷料在经外周静脉穿刺置入中心静脉导管穿刺点重度感染中的应用

Clinical observation of alginate dressing in the treatment of PICC puncture point severe infection in hematological patients

目的探讨海藻盐敷料应用于血液病病人经外周静脉穿刺置入中心静脉导管(PICC)穿刺点重度感染中的临床疗效与护理。方法血液科PICC置管发生穿刺点重度感染病人127例,其中,2011年1月至2015年11月采用海藻盐敷料的病人81例为观察组,2008年9月至2010年12月采用普通敷料的46例为对照组,分别进行穿刺点护理。结果对照组出现非计划性拔管2例,观察组无一例非计划性拔管;观察组病人穿刺点愈合时间(8.15±2.09)d明显短于对照组(12.16±3.85)d(t=7.536,P<0.05),而观察组的SAS评分(32.78±4.80)分要明显低于对照组(38.86±6.35)分(t=6.148,P<0.001),并且换药次数及费用也明显少于对照组(P<0.05)。结论海藻盐敷料在血液病病人PICC穿刺点重度感染治疗过程中能够明显加速愈合时间、减轻护理工作量,同时降低病人焦虑情绪以及经济负担,有着重要的临床意义。

Abstract ： Objective To explore the clinical nursing and application of alginate dressing in the treatment of PICC puncture point se-vere infection among hematological patients. Methods Totally 127 cases of hematological patients with severe infection of puncture point were assigned into two groups by time,of which 81 cases treated from January 2011 to November 2015 adopted alginate dressing, and another 46 cases treated from September 2008 to December 2010 adopted common dressing. Results In the control group, there were 2 cases of unplanned extubation, while there was none in the observation group. The healing time of patients in the observation group was significantly shorter than the control group [（ 8. 15 ± 2. 09） d 仍（ 12. 16 ± 3. 85 ） d, Z = 7. 536,P 〈 0. 05 ] . SAS score of the observation group was significantly lower than the control group [（ 32. 78 ±4. 80）仍 （38. 86 ± 6. 35） ,艺 = 6. 148, P 〈 0. 001 ] and times of dressing and the cost were also significantly lower than the control group （P 〈 0. 05 ） . Conclusions Alginate dressing in treating PICC puncture point severe infection can significantly shorten the healing time,reduce the nursing workload while reducing the financial burden and the anxiety of patients, which has important clinical significance.