中风患者锁骨下中心静脉导管堵塞的原因分析及预防对策

Analysis of Causes and Preventive Strategies of Subclavian Central Venous Catheter Obstruction of Stroke Patients

目的探讨中风患者留置锁骨下中心静脉导管堵塞的主要原因,大致分为患者因素,以及护士因素等,并从长期的护理经验及方法分析有效预防导管堵塞的预防对策。方法对该院2014年1月—2015年12月收治58例中风患者留置锁骨下深静脉置管后,每次输液前需抽回血,再用10 mL预充式导管冲洗液脉冲式冲管,输液结束后需用10 mL预充式导管冲洗液脉冲式冲管,后用稀释肝素液10 mL脉冲+正压封管。结果置管留置时间为14~30 d。该组共有12例发生相关并发症。其中导管堵塞5例。结论正确冲封管方法以及合理选用封管液可以有效避免导管意外堵塞,延长导管使用寿命,达到治疗需要,减轻患者痛苦。

Objective To study the major causes of subclavian central venous catheter obstruction of stroke patients including the patient factor and nurse factor, and analyze the effective prevention strategies of catheter obstruction from the long-term nursing experience and method. Methods 58 cases of stroke patients admitted and treated in our hospital from January 2014 to December 2015 were selected after the subclavian central venous catheterization, and the blood needed to be extracted each time before infusion, and 10 mL precharged catheter washing fluid pulse type pulse tube was used, after the infusion, 10 mL perfilled catheter was required to pulse the pulse tabe,and then the heparin solution10 m L pulse and positive pressure tube sealing was used. Results The catheterization indwelling was 14~30 days,and there were 12 cases with related complications, including 5 cases with catheter obstruction. Conclusion The accurate pulse tube and sealing tube and rational selection of sealing pipe liquid can effectively avoid the accidental obstruction of catheter, prolong the life of catheters, reach the treatment need and relieve the pains of patients.