危险因素评估下针对性护理干预对新生儿PICC静脉炎预防效果分析

Effect of targeted nursing intervention on PICC-associated phlebitis prevention in neonates under risk factor assessment

目的:探究危险因素评估下针对性护理干预对预防新生儿经外周静脉置入中心静脉导管(PICC)导管相关性静脉炎的效果。方法:回顾性分析某三甲医院新生儿重症监护病房2017-2019年1164例经外周置入PICC病人资料信息,根据是否发生PICC静脉炎分为静脉炎组142例,无静脉炎组1022例,经单因素分析发生PICC静脉炎的危险因素。选取2020-2021年PICC置管中出现任何一种或多种危险因素的78例PICC置管患儿为研究对象,随机将78例患儿分为对照组40例与观察组38例,对照组置管成功后予以常规维护护理,观察组置管成功后根据置管过程采取危险因素评估下针对性护理干预。比较2组PICC静脉炎发生率。结果:有静脉炎组置管时体质量低于无静脉炎组(P<0.05),导管尖端位置异位率、送管困难率、置管前未使用0.9%氯化钠溶液20 mL+地塞米松5 mg浸泡导管发生率高于无静脉炎组(P<0.05~P<0.01),2组穿刺静脉位置差异均有统计学意义(P<0.01)。观察组PICC静脉炎发生率明显低于对照组(P<0.01)。结论:危险因素评估下针对性护理干预能降低新生儿PICC导管相关性静脉炎的发生率。

Objective:To explore the effect of targeted nursing intervention on prevention of neonatal peripherally inserted central catheter(PICC)-associated phlebitis under risk factor assessment.Methods:A total of 1164 patients with PICC catheterization in neonatal intensive care unit of a tertiary grade A hospital from 2017 to 2019 were retrospectively analyzed.According to whether PICC-associated phlebitis occurred or not,the patients were divided into the phlebitis group(142 cases)and non-phlebitis group(1022 cases).The risk factors of catheter-associated phlebitis were analyzed by univariate analysis.A total of 78 children with PICC catheterization with any one or more risk factors in PICC catheterization from 2020 to 2021 were selected as the study objects,and randomly divided into control group(40 cases)and observation group(38 cases).The control group was given routine maintenance and care after successful catheterization,and the observation group took targeted nursing intervention based on risk factors assessment during catheterization.The incidence of PICC-associated phlebitis was compared between the two groups.Results:The body weight in the group with phlebitis was lower than that in the group without phlebitis(P<0.05),the incidence of catheter tip position ectopic rate,catheterization difficulty rate,no using of 0.9%sodium chloride injection and 5 mg dexamethasone immersion catheter before catheterization were higher than those in non-phlebitis group(P<0.05 to P<0.01),and the difference of puncture vein between the two groups was statistically significant(P<0.01).The incidence of phlebitis in the observation group was significantly lower than that in the control group(P<0.01).Conclusions:Targeted nursing intervention can reduce the incidence of neonatal PICC-associated phlebitis under risk factor assessment.