水胶体敷料联合自粘弹力绷带在PICC穿刺点渗血、渗液中的应用

Application of Hydrocolloid Dressing Combined with Self-adhesive Elastic Bandage for Bleeding and Exudation at PICC Puncture Site

目的该文主要评估PICC穿刺点渗血、渗液患者在治疗期间应用水胶体敷料联合自粘弹力绷带对止血、止液疗效产生的影响,了解水胶体敷料联合自粘弹力绷带对于换药次数、渗血和渗液持续时间以及皮肤感染造成的影响。方法研究的对象为该院2017年10月—2019年10月期间收治的PICC穿刺患者40例,临床按照随机原则对参与研究的患者进行分组,对照组(20例)在进行治疗期间应用传统无菌纱布进行穿刺点的覆盖,实验组(20例)在进行治疗期间使用水胶体敷料覆盖穿刺点周围,然后使用传统无菌纱布覆盖穿刺点,无菌透明贴膜固定后再使用自粘弹力绷带加压固定,对实验组、对照组取得的治疗效果展开组间的分析和对比。结果实验组应用水胶体敷料联合自粘弹力绷带后换药次数(1.86±0.46)次、渗液持续时间(2.43±0.90)d、治愈时间(2.31±1.27)d优于对照组(2.58±0.35)次、(3.67±0.98)d、(5.89±2.04)d,差异有统计学意义(t=3.808、3.553、6.739,P<0.05);实验组有效率(100%)、治愈率(95%)、皮肤2级感染率(0%)、皮肤1级感染率(5%)、皮肤0级感染率(95%),优于对照组45%、60%、10%、35%、55%,差异有统计学意义(χ^2=10.377、9.148、7.282、9.667、12.049,P<0.05)。结论和患者应用传统无菌纱布进行穿刺点的覆盖相比较,PICC穿刺点渗血、渗液患者在导管维护时应用水胶体敷料联合自粘弹力绷带,可减少换药次数,明显缩短渗血、渗液持续时间,进一步降低穿刺点感染的可能。

Objective This article mainly evaluates the effect of application of hydrocolloid dressing combined with self-adhesive elastic bandage on hemostatic and hemostatic effects during the treatment of patients with bleeding and exudation frequency, duration of bleeding and exudation, and the effects of skin infections at PICC puncture site.Methods The subjects of this study were 40 patients with PICC puncture admitted from October 2017 to October 2019 in the hospital. The patients who participated in the study were divided into clinical groups according to the random principle. The control group(20 cases) applied traditional methods of cover the puncture point with sterile gauze during the treatment. The experimental group(20 cases) covered the puncture point with hydrocolloid dressing during the treatment, and then covered the puncture point with traditional sterile gauze. The sterile transparent film was fixed and then the self-adhesive elastic bandage was used. Pressurized fixation, analysis and comparison between the experimental group and the control group. Results After using hydrocolloid dressing combined with self-adhesive elastic bandage, the experimental group was better than the control group in the number of dressing changes(1.86 ±0.46)times, duration of exudate(2.43±0.90)d, and healing time(2.31±1.27)d, better than the control group of(2.58±0.35)times、(3.67 ±0.98)d、(5.89 ±2.04)d, the difference is statistically significant(t =3.808, 3.553, 6.739, P <0.05);the experimental group’s effectiveness(100%), cure rate(95%), skin level 2 infection rate(0%), skin grade 1 infection rate(5%) and skin grade 0 infection rate(95%) are better than the control group 45%, 60%, 10%, 35%, 55%, and the difference is statistically significant(χ^2=10.377, 9.148, 7.282, 9.667, 12.049, P<0.05). Conclusion Compared with the application of traditional sterile gauze to cover the puncture site, the patients with PICC puncture site bleeding, the use of hydrocolloid dressing combined with self-adhesive elastic bandage during catheter maintenance can reduce the number of dressing changes, significantly reduce bleeding, the duration of the exudate further reduces the possibility of infection at the puncture site.