成人外周静脉留置针使用情况调查

Survey of the use of peripheral venous catheters in adult patients

目的了解成人外周静脉留置针使用现状,为规范使用留置针提供参考。方法采用多阶段抽样,对湖南省14个地州市14所医院1 594例成人患者进行留置针使用情况调查,包括留置针类型、输液接头类型、穿刺部位、冲封管情况、置管侧肢体情况及结局。结果 90.96%的患者使用密闭式留置针,47.99%的患者使用肝素帽接头,45.92%穿刺部位为手背,冲封管液主要为生理盐水(80.93%),脉冲式冲封管占86.20%,输液结束后冲封管占94.98%,置管侧上肢下垂超过1h占40.84%,并发症或不良事件主要为堵管(19.39%)、外渗/渗出(12.67%)、静脉炎(7.28%)。结论临床护士使用留置针的安全防范意识有所提高,但穿刺部位选择、冲封管手法和时机及对患者的健康教育有待加强,以减少并发症的发生。

Objective To describe the status of use of peripheral venous catheters（PVCs）in adult patients and to provide evidence for standardizing catheter use.Methods A total of 1 594 adult patients with PVCs were selected from 14 hospitals of 14 cities in Hunan province by using multi-stage sampling,and catheter features such as catheter type,connector type,insertion site,flushing and locking,activities of the limb,and outcomes were observed.Results More than ninety percent（90.96%）patients used closed-end catheter,47.99% patients used heparin-functionized caps,and 45.92% patients received catheter placement at the back of the hand.For flushing and locking PVCs,normal saline solution was routinely used（80.93%）,intermittent flushing accounted for 86.20% and flushing after completion of infusion accounted for 94.98%.Greater than forty percent（40.84%）patients put their limb with catheter placement downward more than 1 hour.The main complications or adverse events were occlusion（19.39%）,extravasation（12.67%）and phlebitis（7.28%）.Conclusion Clinical nurses′awareness of safe use of PVCs is improved.However,insertion site,flushing and locking techniques,and patient education need to be improved to reduce complications.