经皮肝穿胆道引流患者引流管固定带的应用

Application of drainage tube fixation belt in patients receiving percutaneous transhepatic cholangial drainage

目的自行设计引流管固定带,应用于梗阻性黄疸行经皮肝穿胆道引流(PTCD)术后患者,评价临床应用效果。方法选取2017年6月至2019年5月收治的116例梗阻性黄疸行PTCD术患者作为研究对象,按入院先后顺序分成观察组和对照组各58例,两组PTCD导管在思乐扣外固定的基础上,观察组采用PTCD引流管固定带作二次固定,对照组采用3M胶布作二次固定。比较两组患者导管脱出率、引流不畅率、二次固定装置周围皮炎发生率、日均二次固定费用、护理时长以及患者满意度。结果观察组导管脱出率、引流不畅率、皮炎发生率、二次固定装置日均费用及护理时长均明显低于对照组(P<0.05),患者满意度高于对照组,差异有统计学意义(P<0.05)。结论 PTCD术后使用引流管固定带作二次固定,能降低导管脱出、引流不畅和固定处皮炎发生率,减轻护理工作量,减少医疗费用,提升患者满意度,值得临床推广应用。

Objective To evaluate the clinical application effect of self-designed drainage tube fixation belt in patients with obstructive jaundice after receiving percutaneous transhepatic cholangial drainage(PTCD). Methods A total of 116 admitted patients with obstructive jaundice, who received PTCD during the period from June 2017 to May 2019, were collected as the subjects of study. According to the order of admission, the patients were divided into study group(n=58) and control group(n=58). In both groups PTCD drainage catheter were externally fixed with stat-lock, addition to which in the study group drainage tube fixation belt was used to make the secondary fixation and in the control group 3 M tape was employed to make the secondary fixation. The catheter prolapsing rate, the inadequate drainage rate, the incidence of dermatitis around secondary fixation device, the mean medical cost of secondary fixation per day, the daily nursing care time and patient’s satisfaction with nursing were compared between the two groups. Results The catheter prolapsing rate, the inadequate drainage rate, the incidence of dermatitis, the mean medical cost of secondary fixation per day, and the daily nursing care time in the study group were remarkably lower than those in the control group(P<0.05), while the degree of patient’s satisfaction with nursing in the study group was obviously higher than that in the control group(P<0.05). Conclusion The use of drainage tube fixation belt to make secondary fixation after PTCD procedure can reduce the incidence of catheter prolapse, inadequate drainage and dermatitis around secondary fixation device, besides it can lighten the workload of nurses, save medical cost and improve patient’s satisfaction with nursing. Therefore, this technique is worthy of clinical application.