老年危重患者中心静脉置管的护理措施总结

Discussion on how to improve the central venous catheterization in elderly patients

目的总结老年危重患者中心静脉置管的护理措施,延长留置时间。方法回顾性分析我院2014年3月—2017年6月进行中心静脉置管的158例老年危重患者临床护理情况。结果患者置管均获成功,中心静脉穿刺留置管(CVC)留置时间15 d～90 d,平均45.25 d,经外周中心静脉置管(PICC)留置时间90 d～361 d,平均204.68 d,无1例发生空气栓塞,发生穿刺点局部皮肤感染3例,堵管5例;因发热疑似导管相关性感染3例,确诊1例。结论置管时严格无菌技术,维护时严格遵守操作规程可明显提高老年危重患者中心静脉导管的留置时间。

Objective To summarize the clinical experience and nursing measures of elderly critically ill patients with central venous catheterization,and to explore how to prolong the duration of catheter indwelling.Methods The clinical data of 158 elderly critically ill patients undergoing deep vein catheterization in our hospital from March 2014 to June 2017 were retrospectively analyzed.Results All the cases were successfully inserted.CVC retention time was 15-90 days,mean catheterization time was 45.25 days,PICC catheterization time was 90-361 days,mean catheterization time was 204.68 days,No case of air embolism,puncture point local skin infection occurred in 3 cases,5 cases of occlusion.Suspected catheter-related fever due to fever in 3 cases,diagnosed in 1 case.Conclusions Strict aseptic technique during catheterization and strict adherence to procedures during maintenance can significantly improve the retention time of the central venous catheter.