白血病患者不同时机行PICC发生非计划性拔管的危险因素

Risk Factors of Unplanned Extubation in Patients with Leukemia Underwent PICC at Different Times

目的:分析白血病患者不同时机行经外周静脉穿刺中心静脉置管(PICC)发生非计划性拔管的危险因素。方法:选取2018年5月-2020年2月本院收治的86例进行PICC辅助化疗的白血病患者作为研究对象,其中38例于缓解期行PICC,48例于非缓解期行PICC。比较不同时机行PICC发生非计划性拔管情况,分析不同时机行PICC非计划性拔管的危险因素。结果:38例于缓解期行PICC患者发生非计划性拔管18例,发生率为47.37%(18/38);48例于非缓解期行PICC患者发生非计划性拔管36例,发生率为75.00%(36/48),于缓解期行PICC非计划性拔管发生率低于非缓解期(P<0.05)。缓解期与非缓解期行PICC,非计划性拔管者发生静脉血栓、静脉炎、渗血渗液、感染及导管堵塞的例数均多于计划性拔管者(P<0.05)。静脉血栓、静脉炎、感染、渗血渗液和导管堵塞均为缓解期和非缓解期行PICC白血病患者非计划性拔管的独立危险因素(P<0.05)。结论:白血病患者于缓解期行PICC非计划拔管发生率较低。静脉血栓、静脉炎、感染、渗血渗液和导管堵塞均为白血病患者缓解期和非缓解期行PICC非计划性拔管的独立危险因素。在临床护理中应针对上述危险因素采取针对性预防与护理措施,提升PICC辅助白血病患者化疗的效果。

Objective:To analyze the risk factors of unplanned extubation in patients with leukemia underwent peripherally inserted central catheter(PICC)at different times.Method:A total of 86 leukemia patients admitted to our hospital from May 2018 to February 2020 underwent PICC assisted chemotherapy were selected as study subjects.Among them,38 patients underwent PICC in remission stage and 48 patients underwent PICC in non-remission stage.The unplanned extubation of PICC at different times was compared and the risk factors of unplanned extubation of PICC at different times were analyzed.Result:There were 18 cases of unplanned extubation in 38 patients underwent PICC in remission stage,with incidence of 47.37%(18/38).There were 36 cases of unplanned extubation in 48 patients underwent PICC in non-remission stage,with incidence of 75.00%(36/48).The incidence of unplanned extubation of PICC in remission stage was lower than that in non-remission stage(P<0.05).PICC in remission and non remission period,the number of patients with venous thrombosis,phlebitis,exudation,infection and catheter blockage in unplanned extubation were more than those with planned extubation(P<0.05).Venous thrombosis,phlebitis,infection,exudate and catheter blockage were independent risk factors for unplanned extubation in leukemia patients underwent PICC in remission and non remission period(P<0.05).Conclusion:The incidence of unplanned extubation of patients with leukemia underwent PICC in the remission stage is low.Venous thrombosis,phlebitis,infection,extravasation,and catheter blockage are independent risk factors for unplanned extubation in leukemia patients underwent PICC in remission and non-remission period.In clinical nursing,targeted prevention and nursing measures should be taken for the above risk factors to improve the effect of chemotherapy assisted by PICC in leukemia patients.