藻酸盐敷料联合弹力绷带在大疱表皮松解型药疹患者PICC置管后的护理应用

Nursing application of alginate dressing combined with elastic bandage in patients with bullous epidermolytic necrotic drug eruption after PICC catheterization

目的:探讨藻酸盐敷料联合弹力绷带在大疱表皮松解型药疹患者经外周静脉置入中心静脉导管(PICC)置管后的护理应用效果。方法:将我科2020年2月至2021年3月收治的3例大疱表皮松解型药疹患者作为研究对象。在PICC置管常规维护方法基础上,采用改良固定方法:藻酸盐敷料剪成Y型,覆盖在穿刺部位,导管外漏端由开口处穿过并双"U"字形放置于藻酸盐上方,穿刺口周边糜烂面全部用藻酸盐覆盖包裹完整,再用透明敷贴将穿刺口上臂覆盖的藻酸盐环形包扎,最后将网状弹力绷带固定于透明敷贴与藻酸盐敷料上方。结果:经过精心护理,3例患者均未发生导管相关性并发症及导管意外事件,且穿刺口周边皮肤完全愈合。结论:藻酸盐敷料联合弹力绷带在大疱表皮松解型药疹患者PICC置管后的护理效果明显,值得临床推广。

Objective:To explore the nursing effect of alginate new dressing combined with elastic bandage in patients with bullous epidermolytic necrotic drug eruption after PICC catheterization. Methods: We evaluated the status of PICC in 3 patients diagnosed with bullous epidermolytic necrotic drug eruption admitted to our department from February 2020 to March 2021. An improved fixation method is adopted on the basis of conventional maintenance method of PICC catheter. Briefly, the alginate dressing was cut into a Y shape, covering the puncture site. The outer leaking end of the catheter was inserted through the opening and placed over alginate dressing in a double "U" shape. The erosion surface of skin lesion around the puncture port was completely covered with alginate, and then the alginate covered on the upper arm of the puncture port was wrapped in a circular shape with a transparent applicator. Finally, the mesh elastic bandage was fixed on the transparent applicator and the alginate dressing. Results:After careful care, the 3 patients had no catheter-related complications or accidents. The skin around the puncture port was completely healed. Conclusion: The new dressing combined with elastic bandage has a significant nursing effect in patients with bullous epidermolytic necrotic drug eruption after PICC catheterization, and it is worthy of further clinical promotion.