层流病房白血病患儿PICC堵管原因分析和护理对策

Causes of PICC blockage in children with leukemia in laminar flow ward and nursing countermeasures

目的分析层流病房白血病患儿PICC堵管原因,探讨预防堵管的护理对策。方法2019年6月—2020年6月在层流病房行造血干细胞移植期间发生经外周中心静脉置管(PICC)堵管患儿10例,查阅其临床资料,分析PICC堵管发生原因,并对患儿针对性护理干预效果进行总结评估。结果导致堵管的原因包括患儿自身因素、导管因素、输注血制品、采取血标本、输液速度慢、使用输液泵、药物性堵管、封管操作不规范以及层流病房的特殊性等;通过对症护理、更换连接器、尿激酶溶栓通管等方法,9例患儿PICC导管恢复正常使用,仅有1例堵管溶栓失败导致拔管。结论层流病房白血病患儿PICC堵管原因多,应积极预防和早期发现,降低堵管发生率,提高治疗效果。

Objective To analyze the causes of blockage of PICC in children with leukemia in laminar flow ward,and to explore the nursing countermeasures to blockage.Methods From June 2019 to June 2020,10 children who admitted to the laminar flow ward and suffered from PICC catheter blockage during transplantation were selected,their clinical data were reviewed,the causes of PICC catheter blockage were analyzed,and the effect of targeted nursing interventions for children was evaluated.Results The causes of catheter blockage in this group of children included their own factors,catheter factors,transfusion of blood products,collection of blood samples,slow speed infusion,using infusion pumps,drug-induced catheter blockage,irregular catheter sealing operation.Through symptomatic nursing,connector replacement,urokinase thrombolysis tube and other methods,PICC catheter of 9 children in this group restored to normal use,and only 1 case failure in thrombolytic tube plugging led to extubation.Conclusions There are many causes of PICC blockage in children with leukemia in laminar flow ward.Active prevention and early detection should be taken to reduce the incidence of blockage and improve the therapeutic effect.