透明敷料联合粘性敷料在经皮肝穿刺胆道引流术管路固定的应用

Application of combination use of transparent dressing and adhesive dressing in fixing the catheter of percutaneous transhepatic biliary drainage

目的 探讨透明敷料IV3000联合粘性敷料在经皮肝穿刺胆道引流术(PTBD)患者管路固定中的应用效果。方法 将2019年7月至2021年3月在介入专科护理门诊行PTBD引流管维护的患者按就诊先后顺序分为两组:观察组194例,采用IV3000联合爱立敷固定导管,对照组200例,采用常规的蝶形导管固定装置思乐扣固定导管。1周后比较两组的固定牢固度、医用粘胶相关性皮肤损伤(MARSI)、器械相关性压力性损伤(DRPI)、材料费用、护理耗时、患者舒适度和满意度、护士评价得分等情况。结果 观察组的MARSI发生率、材料费用和护理耗时分别为2.58%、(85.00±0.00)元和(6.61±1.28) min,低于对照组的10.50%、(156.40±0.80)元和(12.08±2.22) min;观察组的患者舒适度、满意度、护士评价得分分别为94.33%、96.91%、(8.45±0.75)分,高于对照组的84.50%、88.00%、(8.05±0.68)分,上述指标比较,差异均有统计学意义(P<0.05)。两组导管均固定牢固,未发生脱管或管路移位现象,未见明显DRPI现象。结论 透明敷料IV3000联合粘性敷料爱立敷能有效固定PTBD导管,较思乐扣组不良反应少,材料费用和护理耗时更低,患者舒适度和满意度较高,可在临床推广应用。

Objective To investigate the application effect of combination use of transparent dressing IV3000 and adhesive dressing AllevynThin in fixing the catheter of percutaneous transhepatic biliary drainage(PTBD).Methods Using quasi-experimental design,the patients,who received maintenance of PTBD drainage catheter at the interventional specialized nursing clinic between July 2019 and March 2021,were divided,according to their order of medical visit,into observation group(n=194) and control group(n=200).IV3000 together with AllevynThin was used to fix the PTBD catheter for the patients of the observation group,while conventional butterfly catheter fixation device StatLock was used to fix the PTBD catheter for the patients of the control group.One week after treatment,the fixation firmness,medical adhesive-related skin injury(MARSI),device-related pressure injury(DRPI),material cost,consuming time of nursing,patient comfort and satisfaction,and nurse evaluation score were compared between the two groups.Results The incidence of MARSI,material cost and consuming time of nursing in the observation group were 2.58%,(85.00±0.00) RMB and(6.61±1.28) min respectively,which were lower than 10.50%,(156.40±0.80) RMB and(12.08±2.22) min respectively in the control group.The patient comfort,satisfaction and nurse evaluation score in the observation group were 94.33%,96.91% and(8.45±0.75) points respectively,which were higher than 84.50%,88.00% and(8.05±0.68) points in the control group.The differences in the above items between the two groups were statistically significant(P<0.05).The catheters in both groups were fixed firmly,no detachment or displacement of catheter occurred,and no DRPI signs were observed.Conclusion The combination use of transparent dressing IV3000 and adhesive dressing AllevynThin can effectively fix PTBD catheters.Compared with StatLock,IV3000 together with AllevynThin has several advantages such as less adverse reactions,lower material cost,less consuming time of nursing,satisfactory patient comfort and higher satisfaction degree.Therefore,this method is worth popularizing in clinical practice.(J Intervent Radiol,2022,31:397-400)