纵膈肿瘤患者经上肢PICC置管及护理

A study on patients with mediastinal tumors treated by PICC catheter in upper limbs and nursing care

目的:讨论纵膈肿瘤病人经上肢PICC置管及护理。方法:回顾性分析10例纵膈肿瘤病人行上肢PICC置管的操作方法、术后护理和相关并发症的预防。结果:10例病人行PICC置管,左上肢和右上肢置管分别为4例和6例。所有病人的顺利完成化疗。10位病人管道的留置时间为3~12(7.58±1.00)月。10位病人在PICC应用中,导管内液体流畅,未出现感染、堵管、血栓、穿刺点出血等并发症。结论:纵膈肿瘤患者,除常规PICC术前评估外,根据肿瘤的大小、压迫的程度同时核查胸部CT、上肢血管彩超等情况进行全面评估后制定的置管方案,由资深置管者操作、医护合作,严密的术中监护,细致的术后护理,或可行上肢PICC置管。

Objective： To analyse the various surgery programs on mediastinum tumor patients who accepted PICC catheter in upper limbs, and to discuss the methods of nursing care. Methods： The surgery programs, postoperative nursing and complications prevention used in 10 mediastinum tumor patients who accepted PICC catheter in upper limbs were retrospectively analyzed. Results： A total of 10 cases of PICC catheter, including 4 cases of left upper limb and 6 cases of right upper limb with PICC, were completed successfully with complete preoperative assessment. After careful nursing, all patients completed chemotherapy successfully, whose tube indwelling time from 3 to 12 months, without unscheduled extubation. In the application of PICC catheter, 10 patients showed smooth fluid in the catheter and no complications such as infection, blockage, thrombus and puncture bleeding. Conclution： Patients with mediastinum tumor should be comprehensively assessed by colour-Doppler ultrasound in upper limbs and the chest CT which help to check the size and compression degree of tumors, in addition to the regular preoperative evaluation of PICC. The PICC operations in upper limbs should be made by seasoned operators as well as good doctor-nurse cooperation. Besides, the patients should be closely monitored during operation and given by careful postoperative nursing care.