置管前备皮对早产儿PICC维护效果的影响

Effect of skin preparation before catheter on maintenance of PICC in premature infants

目的探讨置管前备皮对早产儿PICC维护效果的影响。方法将需行PICC置管的住院早产儿按编号排序,奇数分为备皮组267例,偶数分为非备皮组268例。两组PICC穿刺操作及导管维护均由3名取得PICC专科护士培训合格证书的高年资护师完成,非备皮组按常规行PICC置管,备皮组在PICC置管前剃除胎毛。结果备皮组皮肤破损发生率显著低于非备皮组,更换敷贴所用时间较非备皮组显著缩短,疼痛评分显著低于非备皮组(均P<0.01);两组穿刺处皮肤感染率比较,差异无统计学意义(P>0.05)。结论 PICC置管前备皮能显著降低更换敷贴时对患儿皮肤造成的撕脱损伤,减轻患儿疼痛,并缩短更换敷贴时间。

Objective To explore the effect of skin preparation before catheter on the maintenance of PICC in premature infants.Methods Hospitalized premature infants who need PICC catheterization were ordered according to admission number,then the odd numbers were treated as a skin preparation group（n=267）and the even numbers were treated as a non skin preparation group（n=268）.PICC puncture operation and catheter maintenance of the two groups were completed by 3 senior nurses,who received qualification certificate after completed PICC specialist nurse training,and the non skin preparation group received PICC catheter by a routine manner,while the skin preparation group were shaved lanugo hair before catheter.Results The incidence of skin breakage of the skin preparation group was significantly lower than that of the non skin preparation group,the time consuming for dressing change was significantly shorter than that of the non skin preparation group,and the pain assessment score was significantly lower than that of the non skin preparation group（P0.01 for all）,while there was no significant difference in skin infection rate between the two groups（P0.05）.Conclusion Skin preparation before PICC catheter can significantly reduce the avulsion injury to the skin of premature infants during dressing change,relieve their pain,and shorten time consuming of dressing change.