基于FMEA理论护理对PICC置管后深静脉血栓预防效果研究

Effect of nursing care on prevention of deep venous thrombosis after PICC catheterization based on FMEA theory

目的探讨基于失效模式与效应分析(FMEA)理论护理对经外周静脉置入中心静脉导管(PICC)置管后深静脉血栓的预防效果。方法选取2015年7月至2017年8月就诊于该院的恶性肿瘤患者共82例作为研究对象,82例患者分为试验组(41例)和对照组(41例)。所有患者均行PICC置管化疗,化疗期间给予对照组常规护理干预,试验组在常规护理基础上实施基于FMEA理论护理,比较两组护理效果。结果两组失效模式的危急值(RPN)比较,试验组均低于对照组(P<0.05),提示对照组患者发生深静脉血栓等并发症的风险明显高于试验组;深静脉血栓及其他并发症发生率比较,试验组明显低于对照组(P<0.05);护理干预前,两组患者血管扩张反应(FMD)、内皮微粒(EMCs)水平比较差异无统计学意义(P>0.05),护理后对照组FMD水平均明显低于护理前和试验组(P<0.05),EMCs明显高于护理前和试验组(P<0.05);护理总满意率比较,试验组明显高于对照组(P<0.05)。结论给予PICC置管患者基于FMEA理论护理,可明显降低深静脉血栓等并发症发生率,减少患者血管损伤,提升护理满意度,值得推广。

Objective To investigate the effect of nursing care on the prevention of deep venous thrombosis after PICC catheterization based on FMEA theory.Methods A total of 82 patients with malignant tumors who visited the hospital from Jul 2015 to Aug 2017 were selected as study subjects.82 patients were divided into experimental group(41 cases)and control group(41 cases).All patients received PICC catheterization chemotherapy.During the chemotherapy period,the control group received routine nursing intervention.The experimental group performed FMEA theoretical nursing on the basis of routine nursing care and compared the nursing effects.Results The RPN values of the two groups of failure modes were lower in the experimental group than in the control group(P<0.05),suggesting that the risk of complications such as deep vein thrombosis was significantly higher in the control group than in the experimental group;The incidence of deep venous thrombosis and other complications was significantly lower in the experimental group than in the control group(P<0.05).There was no significant difference in FMD and EMCs levels between the two groups before the nursing intervention(P>0.05).After the nursing,the control group was FMD.The average level of the patients was significantly lower than that of the pre-care and experimental groups(P<0.05),and the EMCs were significantly higher than those of the pre-care and experimental groups(P<0.05).The total nursing satisfaction rate was significantly higher in the experimental group than in the control group(P<0.05).Conclusion According to FMEA theoretical nursing,PICC catheterization can significantly reduce the incidence of complications such as deep vein thrombosis,reduce vascular injury,and improve nursing satisfaction.It is worth promoting.