晚期妊娠并发乳腺癌患者建立中心静脉通路的风险管理1例

Risk management of establishing central venous access in a patient with breast cancer during late pregnancy:a case report

总结1例晚期妊娠并发乳腺癌患者在治疗期间建立静脉通路的护理体会。护理要点:静脉导管置管前全面评估患者及胎儿情况,排除禁忌后,选择合适的静脉导管和置管路径,做好应急预案;置管时采取合适的体位,准确预测导管长度,优化置管流程,全程严密监护,确保患者及胎儿安全;置管后实施个体化护理,预防并发症。患者成功留置左上肢外周中心静脉导管(peripherally inserted central venous catheter,PICC),行第一次化疗后,在化疗间歇期妊娠满37周时顺利产下胎儿,治疗完成后顺利拔除导管,且无相关并发症。

To summarize the nursing experience of a case of late pregnancy complicated with breast cancer during the treatment of venous access.Nursing points include comprehensive assessment of patient's and fetal conditions before intravenous catheter catheterization,selection of appropriate intravenous catheter and catheterization path after exclusion of contraindications and preparation of emergency plans.Appropriate position should be adopted during catheterization to predict the length of catheter accurately,optimize the catheterization process,and monitor the whole process strictly to ensure the safety of the patient and fetus.Implement individualized nursing after catheterization to prevent complications.The patient successfully placed a peripherally inserted central venous catheter(PICC)through a peripheral vein in the left upper extremity,delivered a fetus successfully at 37 weeks of gestation during the interval of chemotherapy after the first chemotherapy,and removed the catheter successfully after completion of treatment without associated complications.