恶性肿瘤患者经外周静脉置入中心静脉导管的循环护理干预

Circulation nursing intervention for malignant tumor patients with peripherally inserted central catheter

目的探讨计划-执行-检查-行动(PDCA)循环护理干预对恶性肿瘤患者经外周静脉置入中心静脉导管(PICC)并发症的预防效果。方法选取PICC置管的94例恶性肿瘤患者,随机分为对照组和观察组各47例。对照组给予PICC常规护理,观察组在对照组基础上开展PDCA循环护理干预,均通过电话或门诊形式随访6个月。比较2组PICC置管效果,记录常见并发症发生情况。结果观察组一次性穿刺成功率、患者PICC满意率均高于对照组(P<0.05),观察组留置导管时间(28.06±2.93)d长于对照组(21.58±3.27)d(P<0.05)。2组PICC相关感染、静脉炎、导管移位和堵塞发生率比较差异均无统计学意义(P>0.05),观察组渗血发生率、非计划拔管发生率均低于对照组(P<0.05)。结论PDCA护理干预能显著提高恶性肿瘤PICC患者一次性穿刺成功率,延长留置导管时间,有效预防渗血和非计划性拔管等置管并发症发生,提高患者满意率。

Objective To explore the preventive effect of Plan-Do-Check-Action(PDCA)circulation nursing intervention on the complications of malignant tumor patients with peripherally inserted central catheter(PICC).Methods Totally 94 patients with malignant tumors by PICC were randomly divided into control group and observation group,with 47 cases in each group.The control group was given PICC routine nursing,and the observation group was given PDCA circulation nursing intervention on the basis of the control group.All patients were followed up for 6 months by telephone or outpatient.The results of PICC catheterization were compared between the two groups,and the common complications were recorded.Results The success rate of one-time puncture and the satisfaction degree of PICC in the observation group were significantly higher than those in the control group(P<0.05).The indwelling time of catheter in the observation group was(28.06±2.93)days,which was significantly longer than(21.58±3.27)days in the control group(P<0.05).The incidence rates of PICC-related infection,phlebitis,catheter displacement and blockage showed no significant differents between the two groups(P>0.05).Conclusion PDCA nursing intervention can significantly improve the success rate of one-time puncture of malignant tumors patients with PICC,prolong the indwelling time of catheter,effectively prevent the complications of catheterization such as bleeding and unplanned extubation,and improve the satisfaction degree of patients.