ICU中等量胸腔积液患者静脉留置导管的综合护理分析

Comprehensive Nursing Analysis of Venous Indwelling Catheter in Patients with Moderate Pleural Effusion in ICU

目的探讨ICU中等量胸腔积液患者静脉留置导管的综合护理效果。方法选取2016年3月—2017年3月期间我院ICU收治的220例胸腔积液患者进行研究,随机分为观察组和对照组,每组各110例。观察组采取胸腔静脉留置导管抽液,给予综合护理方案,对照组采取常规胸腔穿刺抽液。比较两组患者治疗前后的心率(HR)、呼吸(R)、氧合指数(PO2/FiO2),比较两组患者的并发症和不良反应发生情况以及穿刺次数和治疗费用。结果在治疗前和治疗后,观察组和对照组的HR、R和PO_2/FiO_2相比,差异不具有统计学意义(P>0.05)。两组治疗后的HR、R和PO_2/FiO_2指标与治疗前相比均有显著变化,差异具有统计学意义(P<0.05)。观察组患者出现导管堵塞或脱出的发生率为7.20%。观察组的胸膜反应发生率(0.90%)显著低于对照组(6.40%),差异有统计学意义(P<0.05)。两组患者的气胸、局部感染的发生率相比无显著差异(P>0.05)。观察组平均穿刺(1.4±0.5)次,对照组平均穿刺(3.7±1.8)次,观察组的穿刺次数少于对照组,差异具有统计学意义(P<0.05)。两组患者的治疗费用差异无统计学意义(P>0.05)。结论对ICU中等量胸腔积液患者静脉留置导管采用综合护理,排液效果较好,能够显著减少穿刺次数,减少胸膜反应的发生,未明显增加治疗费用,可在临床上推广。

OBJECTIVE To investigate the comprehensive nursing effect of intravenous indwelling catheter in patients with pleural effusion in ICU METHODS 220 patients with pleural effusion in target hospital ICU from March 2016 to March 2017 were selected for the study, and randomly divided them into observation group and control group, each group had110 cases. The patients in the observation group were given chest vein indwelling catheter drainage, and the comprehensive nursing program was given. The control group received routine chest drainage. The heart rate （HR）, respiratory （R） and oxygenation index （PO2/FiO2） were compared between the two groups before and after treatment. The complications and adverse reactions, the number of times of puncture and the cost of treatment were compared between the two groups. RESULTS Before treatment and after treatment, the difference of HR, R and PO2/FiO2 in the observation group and the control group were not statistically significant （P〉0.05）. The HR, R and PO2/FiO2 indexes of the two groups after treatment had significant changes compared with before treatment, the difference was statistically significant （P〈0.05）. The incidence of catheter obstruction or prolapse in the observation group was 7.2%. The incidence of pleural reaction in the observation group （0.9%） was significantly lower than that in the control group （6.4%）, and the difference was statistically significant （P〈0.05）. There was no significant difference in the incidence of pneumothorax and local infection between the two groups （P〉0.05）, The average puncture （1.4±0.5） times in the observation group, the average puncture （3.7±1.8） times in the control group, and the number of puncture in the observation group was less than that in the control group, the difference was statistically significant （P〈0.05）. There was no significant differ- ence in the cost of treatment between the two groups （P〉0.05）. CONCLUSION On the comprehensive nursing of indwelling catheter in ICU with pleural effusion of patients with venous drainage, the effect was good, which could significantly reduce the number of puncture, reduce pleural reaction, without increasing the cost of treatment, could be popularized in clinical.