视网膜母细胞瘤患儿行PICC术的疼痛干预研究

Study on the pain intervention for children with retinoblastoma undergoing PICC

目的探讨视网膜母细胞瘤患儿行中心静脉置管(PICC)术的疼痛干预方法。方法选取行PICC穿刺的视网膜母细胞瘤患儿80例,随机分为实验组40例和对照组40例。实验组采取穿刺前60 min局部涂抹复方利多卡因乳膏联合穿刺前30 min水合氯醛灌肠的改良式疼痛干预方法,对照组采用穿刺前60 min局部涂抹复方利多卡因乳膏的常规穿刺局部止痛方法。两组患者均由同一位经验丰富具备PICC高级专科护士资质的工作人员进行PICC穿刺。比较两组患儿疼痛情况、置管成功率、皮下出血率及操作时间。结果采取改良式疼痛干预方法后,患儿疼痛感进一步降低,PICC置管成功率明显提高、皮下出血率大大降低、护士操作时间明显减少。两组比较差异有统计学意义(P <0. 05)。结论穿刺前60 min局部涂抹复方利多卡因乳膏联合穿刺前30 min水合氯醛灌肠,相比单纯采用穿刺前60 min局部涂抹复方利多卡因乳膏的常规穿刺局部止痛方法,能进一步减轻患儿的疼痛,并且有效减轻了因为患儿恐惧、不合作、哭闹扭动而带来的一系列负面影响。该改良式疼痛干预方法安全、简便、有效,在视网膜母细胞瘤患儿行PICC穿刺中具备良好的应用效果。

Objective To explore the pain intervention methods for children with retinoblastoma undergoing PICC. Methods Eighty children with retinoblastoma undergoing PICC were selected and randomly divided into experiment group( n =40)and control group ( n =40).The experiment group was given compound lidocaine cream on puncture point and chloral hydrate enema before puncture; the control group was given compound lidocaine cream on puncture point. In both groups, PICC puncture was performed by the same nurse qualified as a senior specialist nurse in PICC. The pain, successful rate of catheter, subcutaneous bleeding rate and operation time were observed and compared. Results After adopting the improved pain intervention method, the pain of the child was further reduced, the success rate of PICC placement was significantly improved, the rate of subcutaneous bleeding was greatly reduced, and the operation time of the nurse was significantly reduced. The difference between the two groups was statistically significant ( P <0.05). Conclusions Compared with giving compound lidocaine cream on puncture point only,Given compound lidocaine cream on puncture point and chloral hydrate enema before puncture is a safe, effective and simple pain intervention method. It can further alleviate the pain of children, and effectively reduce the negative effectively reduce the negative effects caused by children's fear, non-cooperation, crying and writhing. The method has a good application effect in the PICC puncture of children with retinoblastoma.