临床护理干预对超声引导下改良塞丁格穿刺置管化疗效果的影响

Influence of clinical nursing intervention on modified chemotherapeutic effect of Seldinger puncture cathetering under ultrasound guidance

目的 探讨临床护理干预用于超声引导下改良塞丁格穿刺置管化疗的效果及可行性.方法 选取2015年3月～2016年12月该科颈胸部恶性肿瘤患者120例为研究对象,按随机数字表法分为对照组和干预组各60例,对照组采用传统盲穿法行PICC置管,干预组采用超声引导下改良塞丁格技术行PICC置管,并给予临床护理干预,对两组的一次穿刺成功率、置管成功率以及并发症发生情况进行比较.结果 干预组患者的一次穿刺成功为58例（96.7%）,置管成功率为98.3%,对照组患者一次穿刺成功为47例（78.3%）,置管成功率为83.3%,干预组的一次穿刺成功率以及置管成功率明显高于对照组,差异有统计学意义（P〈0.05）;干预组患者有3例（5.0%）发生并发症,对照组有12例（20.0%）发生并发症,差异有统计学意义（P〈0.05）.结论 超声引导下改良塞丁格穿刺置管能够在一定程度上提升化疗患者穿刺成功率,配合相应的临床护理干预,能够降低并发症发生率,效果显著,可在临床中推广应用.

Objective To investigate the effect and feasibility of clinical nursing intervention on improving chemotherapeutic effect of Seldinger puncture cathetering under ultrasound guidance.Methods Retrospective analysis method was used to choose 120 neck-thoracic malignant tumor patients of the department from March, 2015 to December, 2016 as the research objects,which were divided into control group and observation group according to the method of random number table.Traditional blind puncture method was used in control group to have PICC cathetering.Modified seldinger technique was used in observation group to have PICC cathetering with clinical nursing intervention under ultrasound guidance.The once puncture success rate,cathetering success rate and complications were compared.Results The number of patients that had once puncture success in intervention group was 58,which occupied 96.7%.The cathetering success rate was 98.3%.The number of patients that had once puncture success in control group was 47,which occupied 78.3%.The cathetering success rate was 83.3%.The once puncture success rate and cathetering success rate of intervention group were obviously higher than control group,and the difference had statistical significance（P〈0.05）.3 patients of intervention group appeared complications, which occupied 5.0%.12 patients of control group appeared complications,which occupied 20.0%, and the difference had statistical significance（P〈0.05）.Conclusion To a certain degree,modified seldinger puncture cathetering can promote the puncture success rate of chemotherapeutic patients under ultrasound guidance.With the corresponding clinical nursing intervention,the occurrence rate of complications can be reduced that the effect is remarkable,which is worth having popularization and application.