PICC置管肺癌患者化疗间歇期的家庭自我护理干预

Application of home-based self-care interventions for lung cancer patients with peripherally inserted central catheter during the intermission of chemotherapy

目的探讨经外周静脉穿刺置入中心静脉导管(PICC)的肺癌患者化疗间歇期引入家庭自我护理对其并发症及导管护理情况的影响。方法选取2015年3月—2017年8月收治的88例肺癌并以PICC作为化疗通路的患者,随机分为对照组与研究组,各44例。对照组给予肺癌化疗间歇期常规护理,研究组在对照组的基础上采用家庭自我护理干预。观察2组护理期间护患沟通情况、导管护理情况以及导管相关不良事件发生情况。结果研究组患者电话/微信沟通次数多于对照组,置管时间长于对照组,贴膜更换次数、冲管及封管次数、正压接头更换次数均少于对照组,差异有统计学意义(P <0. 05)。研究组导管相关不良事件及并发症总发生率均低于对照组(11. 36%vs. 31. 82%,4. 55%vs. 18. 18%,P <0. 05)。结论对PICC置管的肺癌化疗间歇期患者开展家庭自我护理干预,能够有效预防导管相关不良事件的发生。

Objective To investigate the clinical efficacy of home-based self-care interven- tions for lung cancer patients with peripherally inserted central catheter （PICC） during the intermission of chemotherapy. Methods Totally 88 lung cancer patients with PICC as a intravenous access for chemotherapy were randomly divided into the control group and the study group, with 44 cases in each group. Patients of both two groups received routine care during the intermission of chemotherapy, and those in the study group were given home-based self-care interventions. The nurse-patient communication, nursing management of PICC and catheter-related complications were observed and compared two groups. Results Patients in the study group had a higher frequency of telephone/Wechat communication with nurses and longer indwelling time compared with those in the control group （P 〈 0.05）. There were fewer times of dressing change, catheter flushing, catheter hub sealing and catheter connection change in the study group than those in the control group （ P 〈 0.05 ）. The overall rates of PICC-related adverse events and PICC-related complications in the study group were lower those in the control group （1.36% vs. 31.82%, 4.55 % vs. 18.18 %, P 〈 0.05 ）. Conclusion The home-based self-care interventions are effec- tively reduce the risk of PICC-rated adverse events or complications in lung cancer patients with PICC during the intermission of chemotherapy.