集束化护理对肿瘤患者PICC置管发生深静脉血栓的疗效观察

杨贵丽; 郑海燕

doi:10.13898/j.cnki.issn.1000-2200.2016.04.037

集束化护理对肿瘤患者PICC置管发生深静脉血栓的疗效观察

Effect of bundle nursing on decreasing deep venous thrombosis in tumor patients with peripherally inserted central catheter catheterization

摘要

摘要: 目的:观察集束化护理对肿瘤患者经外周静脉置入中心静脉导管(PICC)发生深静脉血栓的疗效。方法:选择2013年收治的64例肿瘤PICC置管患者为对照组给予常规护理,2014年收治的68例为观察组给予集束化护理。观察2组患者PICC深静脉血栓的发生情况。结果:(1)穿刺静脉与血栓发生的关系。选择头静脉:观察组7例(10.3%),对照组28例(43.8%);选择贵要静脉:观察组61例(89.3%),对照组36例(56.2%),差异有统计学意义(P<0.01)。头静脉置管发生血栓例数:观察组1例(14.2%),对照组5例(17.9%);贵要静脉置管发生血栓例数:观察组1例(14.2%),对照组6例(16.7%),差异有统计学意义(P<0.05)。(2)置管时间与血栓发生的关系。置管2周:观察组1例(1.5%),对照组8例(12.5%),差异有统计学意义(P<0.05);2个月:观察组3例(4.4%),对照组10例(15.6%),差异有统计学意义(P<0.05);全程:观察组3例(4.4%),对照组12例(18.8%),差异有统计学意义(P<0.01)。(3)导管尖端位置与血栓发生的关系。一次置管到位:观察组65例(95.5%),对照组53例(82.8%),差异有统计学意义(P<0.05);二次调整后到位:观察组67例(98.5%),对照组61例(95.3%),差异无统计学意义(P>0.05);导管调整后血栓发生例数:观察组1例(1.5%),对照组8例(12.5%),差异有统计学意义(P<0.05)。结论:采取集束化护理可降低PICC导致的深静脉血栓的发生率,值得在临床上推广。

Abstract: Objective: To observe the effects of bundle nursing on decreasing deep venous thrombosis in tumor patients with peripherally inserted central catheter(PICC) catheterization. Methods: Sixty-four tumor patients with PICC in 2013(control group) were treated with conventional nursing, and 68 tumor patients in 2014(experimental group) were treated with bundle nursing. The occurrence of deep venous thrombosis in two groups were observed. Results: (1)The cephalic vein in 7 cases from the experimental group(10.3%) and 28 cases from control group(43.8%), and the basilic vein in 61 cases from the experimental group(89.3%) and 36 cases from control group(56.2%) were selected, the differences of the relationship between puncture vein and thrombosis were statistically significant(P<0.01). The thrombosis in cephalic vein catheterization of 1 case from the experimental group(14.2%) and 5 cases from control group(17.9%), and basilic vein of 1 case from the experimental group(14.2%) and 6 cases from control group(16.7%) were found, the differences of the thrombosis in two groups were statistically significant(P<0.05). (2) The thrombosis in 1 case from the experimental group(1.5%) and 8 cases from control group(12.5%) were found after 2 weeks of catheterization, the difference of which was statistically significant(P<0.01). The thrombosis in 3 cases from the experimental group(4.4%) and 10 cases from control group(15.6%) were found after 2 months of catheterization, the difference of which was statistically significant(P<0.05). The thrombosis in 3 cases from the experimental group(4.4%) and 12 cases from control group(18.8%) were found during the whole course of catheterization, the difference of which was statistically significant(P<0.01). (3) For locating catheter in place at one time, the thrombosis in 65 cases from the experimental group(95.5%) and 53 cases from control group(82.8%) were found, the difference of which was statistically significant(P<0.05). For locating catheter in place at two time, the thrombosis in 67 cases from the experimental group(98.5%) and 61 cases from control group(95.3%) were found, the difference of which was not statistically significant(P>0.05). After adjusting the location of catheer, the thrombosis in 1 case from the experimental group(1.5%) and 8 cases from control group(12.5%) were found, the difference of which was statistically significant(P<0.05). Conclusions: The bundle nursing can decrease the occurrence of deep venous thrombosis caused by PICC, which is worthy of promotion in clinic.

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