1例急性髓系白血病患者中心静脉导管相关皮肤损伤的护理

Nursing Care of Central Venous Catheter-Related Skin Injury in a Patient with Acute Myeloid Leukemia

总结了1例急性髓系白血病(M2型)患者中心静脉导管相关皮肤损伤的护理经验。护理要点:针对中心静脉导管相关皮肤损伤的不同表现及风险因素,给予个体化护理方法,包括3M水胶体敷料改善皮下出血,藻酸盐敷料改善穿刺点渗液,生理盐水 + 百多邦 + 无菌纱布敷料换药改善导管穿刺点周围敷料下方的渗出、红斑等症状,同时注重维护过程中粘胶剂粘贴与移除中的细节。患者局部症状得到改善,导管安全留置270 d,顺利完成10个疗程化疗后顺利拔出导管。

The nursing experience of one case of central venous catheter-related skin injury in a patient with acute myeloid leukemia (M2) is summarized. Nursing points: For different manifestations and risk factors of central venous catheter-related skin injury, individualized nursing methods were given, including 3M hydrocolloid dressing to improve subcutaneous bleeding, alginate dressing to im-prove oozing at the puncture point, and saline + Pepto-Bismol + sterile gauze dressing change to improve oozing, erythema and other symptoms underneath the dressing around the puncture point of the catheter, and meanwhile, focusing on the details in the adhesive pasting and removal in the maintenance process. The patient’s local symptoms were improved, the catheter was safely left in place for 270 d, and the catheter was successfully removed after the successful completion of 10 courses of chemotherapy.