体位管理结合藻酸钙伤口敷料护理在肺癌术后患者PICC置管中的应用效果

Application effect of postural management combined with calcium alginate wound dressing nursing in PICC catheterization in patients with lung cancer surgery

目的探究体位管理结合藻酸钙伤口敷料护理对肺癌术后患者经外周静脉穿刺中心静脉导管(PICC)置管后并发症的影响。方法采用便利抽样法,选取2019年8月—2020年8月于信阳市中心医院行PICC置管的肺癌患者468例为研究对象,按照区组随机法分为护理组与对照组,分别为256、212例。对照组采用常规护理干预,护理组采用体位管理结合藻酸钙伤口敷料护理。比较两组治疗前后并发症、康复及治疗满意度情况。结果护理组患者PICC置管第1周红肿感染、渗血、皮肤损伤、静脉炎、颈内静脉异位、血栓的发生率均低于对照组,差异具有统计学意义(P<0.05)。护理组患者静脉血栓发生率低于对照组,差异具有统计学意义(Waldχ^(2)=7.588,P=0.006);不同时间下静脉血栓发生率差异有统计学意义(Waldχ^(2)=18.078,P<0.001)。护理组患者治疗后有粘连例数、重度疼痛例数、愈合时间、瘢痕面积均少于对照组,差异具有统计意义(P<0.05)。共发放满意度评估表468份,回收445份,护理组、对照组分别为244、201份;护理组护理满意度高于对照组,差异具有统计学意义(P<0.05)。结论体位管理结合藻酸钙伤口敷料护理可降低肺癌患者PICC置管后并发症的发生,促进患者康复。

Objective To explore the effect of posture management combined with calcium alginate wound dressing nursing on complications after peripherally inserted central catheter(PICC)catheterization in patients with lung cancer surgery.Methods Using the convenience sampling method,a total of 468 lung cancer patients who underwent PICC catheterization in Xinyang Central Hospital from August 2019 to August 2020 were selected as the research objects.According to the block random method,they were divided into the nursing group(n=256)and the control group(n=212).The control group received routine nursing intervention,while the nursing group received postural management combined with calcium alginate wound dressing nursing.The complications,rehabilitation and treatment satisfaction were compared between the two groups before and after treatment.Results The incidences of redness infection,bleeding,skin injury,phlebitis and ectopic jugular vein thrombosis in the nursing group were lower than those in the control group at the first week of PICC catheterization,and the differences were statistically significant(P<0.05).The incidence of venous thrombosis in the nursing group was lower than that in the control group,and the difference was statistically significant(Waldχ^(2)=7.588,P=0.006).There were statistically significant differences in the incidence of venous thrombosis at different times(Waldχ^(2)=18.078,P<0.001).The number of adhesion cases,the number of severe pain cases,the healing time and the scar area in the nursing group after treatment were all lower than those in the control group,and the differences were statistically significant(P<0.05).A total of 468 satisfaction assessment forms were distributed and 445 were recovered,with 244 and 201 in the nursing group and the control group,respectively.The nursing satisfaction of the nursing group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusions Postural management combined with calcium alginate wound dressing care can reduce the incidence of complications after PICC in patients with lung cancer and promote the recovery of patients.