原发性肝癌患者治疗期经外周静脉穿刺置入中心静脉导管堵管的相关因素与护理对策

发布时间：2018-08-14 11:25

【摘要】：目的:研究原发性肝癌患者治疗期间经外周静脉穿刺置入中心静脉导管(peripherally inserted central catheter,PICC)堵管的相关因素并提出有效护理对策。方法:选取2010年3月1日至2015年12月1日无锡市第二人民医院收治的原发性肝癌患者1 026例为研究对象,记录患者性别、年龄、家族史、吸烟史、基础疾病等基本信息,PICC过程中对患者进行严密观察,记录穿刺部位、有无血液反流、冲管或封管、导管尖端移位及导管折叠等情况,并回顾性分析原发性肝癌患者治疗期间PICC堵管的相关因素。结果:原发性肝癌患者治疗期间PICC堵管26例,占2.6%;影响PICC堵管的危险因素中基础疾病(OR=1.978,P0.05)、血液返流(OR=2.237,P0.05)、导管维护不当(OR=2.161,P0.05)、机械因素(OR=2.643,P0.05)。结论:原发性肝癌患者治疗期间PICC堵管与患者基础疾病、血液反流、导管维护不当、机械性因素等密切相关,因此临床护理中应加强对导管的维护,及时有效冲管、封管,避免血液反流,做到早发现、早处理,从而减少堵管对患者不良影响。
[Abstract]:Objective: To study the related factors of peripherally inserted central catheter (PICC) occlusion in patients with primary hepatocellular carcinoma (PHC) during treatment and provide effective nursing countermeasures. The basic information of sex, age, family history, smoking history and underlying diseases were recorded. During PICC, the patients were closely observed, the puncture site, blood reflux, catheter flushing or sealing, catheter tip displacement and catheter folding were recorded. The correlation between PICC occlusion and catheter folding was analyzed retrospectively. Results: PICC occlusion occurred in 26 patients with primary liver cancer (2.6%). The risk factors of PICC occlusion included basic diseases (OR = 1.978, P 0.05), blood reflux (OR = 2.237, P 0.05), improper catheter maintenance (OR = 2.161, P 0.05), mechanical factors (OR = 2.643, P 0.05). Blood reflux, improper catheter maintenance, mechanical factors are closely related, so clinical nursing should strengthen the maintenance of catheters, timely and effective flushing, sealing, to avoid blood reflux, early detection, early treatment, so as to reduce the adverse effects of blockage on patients.
【作者单位】：无锡市第二人民医院肿瘤科;无锡市第二人民医院护理部;无锡市第二人民医院血液科;
【基金】：市基层适宜卫生技术基金(T201521)~~
【分类号】：R473.73

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