1例老年肺癌患者外周静脉留置针拔管困难的护理

Care of an elderly patient with lung cancer who had difficulty in withdrawing the peripheral intravenous indwelling needle

外周静脉留置针输液广泛应用于临床护理工作中,但因留置针软管延长导致的拔管困难,在临床却十分少见。本文总结1例老年肺癌患者通过外周静脉留置针输入抗癌药物,因外周静脉留置针软管延长导致的拔管困难的护理体会。通过发现并上报、评估外周静脉留置针及穿刺部位皮肤状况、采用局部间断热敷法、超声引导下离心方向按摩、缓慢拔管、检查软管等及时有效的护理措施最终将外周静脉留置针软管顺利完整拔除,并进行拔管后护理以促进创面愈合,最终患者穿刺部位局部皮肤无改变、血管无损伤且未发生其他不良反应,患者顺利出院。因此,本文详细分析发生外周静脉留置针拔管困难的原因、处理和预防措施等,以期为日后护理人员解决同类问题提供参考和借鉴。

Although peripheral intravenous indwelling needle infusion is frequently utilized in clinical care,extubation challenges caused by protracted indwelling needle hose are uncommon in clinical practice.The nursing experience of an older lung cancer patient who had trouble being extubated because of a long peripheral intravenous indwelling needle hose while receiving anti-cancer medications is reported in this study.The removal of the patient's peripheral intravenous needle hose was accomplished with the help of prompt and efficient care techniques,including detection and reporting,evaluation of the skin around the peripheral intravenous needle and the site of the puncture,intermittent local heat application,ultrasound-guided massage in the centrifugal direction,slow extraction and inspection of the hose,and post-extraction care to speed up wound healing.The patient was released with no local skin changes,vascular damage,or other side effects.As a result,this paper provides a detailed analysis of the causes,management,and preventive measures for difficult peripheral intravenous needle removal,intending to serve as a reference for future nursing staff to solve similar problems.