α-氰基丙烯酸酯医用胶联合藻酸钙敷料处置PICC穿刺点顽固性渗液的效果及护理

Treatment and nursing management of intractable exudates at the puncture site after PICC placement by α-cyanoacrylate rapid medical adhesive combined with calcium alginate dressing

目的探讨运用α-氰基丙烯酸酯(α-CA)医用胶联合藻酸钙敷料处置经外周静脉穿刺置入中心静脉导管(PICC)穿刺点顽固性渗液的效果,总结相关护理措施。方法58例PICC置管后1周内发生顽固性渗液患者随机分为观察组和对照组,各29例。对照组在物理热疗后采用常规处置方法,观察组在物理热疗后采用α-CA医用胶联合藻酸钙敷料处置。分别统计2组顽固性渗液处置期间导管滑脱例数、湿疹例数、换药费用、舒适度得分以及穿刺点愈合时间。结果观察组导管滑脱发生率、穿刺点平均愈合时间和平均换药费用低于对照组(P<0.01),观察组湿疹发生率低于对照组(P<0.05),观察组舒适度评分高于对照组(P<0.01)。结论α-CA医用胶联合藻酸钙敷料治疗穿刺点顽固性渗液优势明显,能缩短穿刺点愈合时间,减少换药次数。

Objective To investigate the effect ofα-cyanoacrylate(α-CA)medical glue combined with calcium alginate dressing on the intractable exudates at the puncture site after peripherally inserted central catheter(PICC)intubation,and summarize related nursing measures.Methods Totally 58 patients who suffered intractable exudates in the puncture site within 1 week after PICC intubation were randomly divided into observation group and control group,with 29 cases.The control group used conventional treatment after infrared irradiation,and the observation group usedα-CA medical glue combined with calcium alginate dressing after infrared irradiation.The incidence of catheter tip dislocation,eczema,costs of dressing changes,comfort degree and healing time of puncture site were observed and compared between two groups.Results The incidence of catheter tip dislocation,average healing time of puncture site and costs of dressing changes were lower in the observation group than those in the control group(P<0.01).The incidence of eczema in the observation group was lower than that in the control group(P<0.05).The score of comfort assessment in the observation group was higher than that in the control group(P<0.01).Conclusion Theα-CA medical glue combined with calcium alginate dressing has advantages in treating intractable exudates in the puncture site after PICC placement.The combination treatment is potentially effective to shorten the healing time and reduce the costs of dressing changes.