30度角扩皮潜行固定器控制PICC扩皮出血的效果评价
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摘要
目的评价30度角扩皮潜行固定器对控制B超引导下经外周静脉穿刺置入中心静脉导管术(PICC)出血量的效果。方法选择2016年2月—10月在我院住院的需行PICC置管的患者60例,随机分为试验组和对照组,每组30例。试验组在30度角扩皮潜行固定器下进行纵向扩皮,对照组采用传统方法进行纵向扩皮,比较2组患者扩皮后即刻、第2天、第7天出血差异。结果试验组即刻出血量和第2天出血量明显低于对照组,差异具有统计学意义(P<0.05);2组患者第7天穿刺点出血量差异无统计学意义(P>0.05)。结论在30度角扩皮潜行固定器下行纵向扩皮,可使扩皮角度及深度精确化,缩小穿刺点伤口范围及出血量,值得临床推广和使用。
Objective To explore the effects of 30°-angled incision fixer on controlling the bleeding after ultrasonography guided peripherally inserted central catheter(PICC) operation.Methods Sixty hospitalized patients treated with PICC therapy during February 2016 to October 2016 were recruited. All participants were randomly divided into case and control groups, each group had 30 people. In case group, the skin was longitudinal incised with the help of 30°-angled incision fixer, while in control group, the skin was traditionally longitudinal incised with experience. The bleeding amount was compared during operation, the next day and the 7~(th) day after operation between two groups.Results The bleeding amount was significantly decreased during operation and the next day after operation in case group compared with that of control group(P<0.05), while no difference was observed in bleeding amount on the 7~(th) day after operation between the two groups(P>0.05).Conclusion The 30°-angled incision fixer could make the angle and depth of the incision more precise, thus could narrow the range of wound and reduce the bleeding amount, and it deserves to be popularized and used clinically.
Objective To explore the effects of 30°-angled incision fixer on controlling the bleeding after ultrasonography guided peripherally inserted central catheter(PICC) operation.Methods Sixty hospitalized patients treated with PICC therapy during February 2016 to October 2016 were recruited. All participants were randomly divided into case and control groups, each group had 30 people. In case group, the skin was longitudinal incised with the help of 30°-angled incision fixer, while in control group, the skin was traditionally longitudinal incised with experience. The bleeding amount was compared during operation, the next day and the 7~(th) day after operation between two groups.Results The bleeding amount was significantly decreased during operation and the next day after operation in case group compared with that of control group(P<0.05), while no difference was observed in bleeding amount on the 7~(th) day after operation between the two groups(P>0.05).Conclusion The 30°-angled incision fixer could make the angle and depth of the incision more precise, thus could narrow the range of wound and reduce the bleeding amount, and it deserves to be popularized and used clinically.
引文
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[11]张丽亚.经B超引导下PICC置管扩皮技术常见的并发症及护理[J].中国保健营养,2014,(7):4355.Zhang LY.Common complications and nursing of B-ultrasound guided PICC extraction technology[J].China Health Care&Nutrition,2014,7:4355.
[12]钱薇,吴金凤,言克莉.经B超引导下结合微插管鞘技术行PICC置管术两种扩皮方法的比较[J].护理学报,2012,19(7B):60-62.Qian W,Wu JF,Yan KL.Comparison of two methods of desquamate by PICC under the guidance of B-ultrasound combined with microinterpolation sheath technique[J].Journal of Nursing,2012,19(7B):60-62.doi:10.3969/j.issn.1008-9969.2012.14.023.
[13]陈洁红,郑立,黄木兰,等.经胸前区腋静脉穿刺行中心静脉置管患者的护理[J].南方护理学报,2005,12(5):18-19.Chen JH,Zheng L,Huang ML,et al.Nursing care of patients with central venous catheterization through axillary vein puncture in chest area[J].Nanfang Journal of Nursing,2005,12(5):18-19.doi:10.3969/j.issn.1008-9969.2005.05.007.
[2]Leung TK,Lee CM,Tai CJ,et al.A retro-spective study on the long-term placement of peripherally inserted central catheters and the importance of nursing care and education[J].Cancer Nurs,2011,34(1):25-30.doi:10.1097/NCC.0b013e3181f1ad6f.
[3]曾丽,刘宇,王佳,等.B超导引下改良塞丁格技术两种扩皮方式行中心静脉置管出血量的比较[J].实用医院临床杂志,2013,10(5):145-146.Zeng L,Liu Y,Wang J,et al.Comparison of bleeding volume of central venous catheterization by two modified method of seidinger technique guided by B-ultrasound[J].Practical Journal of Clinical Medicine,2013,10(5):145-146.doi:10.3969/j.issn.1672-6170.2013.05.050.
[4]王丰松,陈慧,翟海玲.疑难重症患者超声引导下中心静脉导管置入的护理[J].中国基层医药,2010,17(15):2154.Wang FS,Chen H,Zhai HL.Nursing care of central venous catheterization guided by ultrasound in difficult and severe patients[J].Chinese Journal of Primary Medicine and Pharmacy,2010,17(15):2154.doi:10.3760/cma.j.issn.1008-6706.2010.15.089.
[5]Wang Q,Wang N,Sun Y.Clinical effect of peripherally inserted central catheters based on modified seldinger technique under guidance of vascular ultrasound[J].Pak J Med Sci,2016,32(5):1179-1183.doi:10.12669/pjms.325.10384.
[6]Chopra V,Ratz D,Kuhn L,et al.PICC-associated bloodstream infections:prevalence,patterns,and predictors[J].Am J Med,2014,127(4):319-328.doi:10.1016/j.amjmed.2014.01.001.
[7]Zhang S,Sun X,Lei Y.The microbiological characteristics and risk factors for PICC-related bloodstream infections in intensive care unit[J].Sci Rep,2017,7(1):15074.doi:10.1038/s41598-017-10037-2.
[8]方云.血液肿瘤患者PICC置管后局部冰敷压迫止血效果观察[J].护理学杂志,2011,26(9):38-39.Fang Y.Observation on the hemostatic effect of local ice compression in patients with blood tumor after PICC tube implantation[J].Journal of Nursing Science,2011,26(9):38-39.doi:10.3870/hlxzz.2011.09.038.
[9]郭洪霞,穆婷婷,李金艳.藻酸盐敷料用于PICC置管术后穿刺点止血的效果观察[J].临床肿瘤学杂志,2012,17(11):1040-1042.Guo HY,Mu TT,Li JY.Observation on the effect of alginate garment on hemostasis at PICC stab[J].Chinese Clinical Oncology,2012,17(11):1040-1042.doi:10.3969/j.issn.1009-0460.2012.11.020.
[10]张媛媛,郭丽娟,张全英.改良塞丁格技术与传统PICC置管在化疗患者中应用比较[J].护理学报,2010,17(17):1-4.Zhang YY,Guo LJ,Zhang QY.Comparison between modified Saidingge technique and traditional PICC tube implantation in chemotherapy patients[J].Journal of Nursing,2010,17(17):1-4.doi:10.3969/j.issn.1008-9969.2010.17.001.
[11]张丽亚.经B超引导下PICC置管扩皮技术常见的并发症及护理[J].中国保健营养,2014,(7):4355.Zhang LY.Common complications and nursing of B-ultrasound guided PICC extraction technology[J].China Health Care&Nutrition,2014,7:4355.
[12]钱薇,吴金凤,言克莉.经B超引导下结合微插管鞘技术行PICC置管术两种扩皮方法的比较[J].护理学报,2012,19(7B):60-62.Qian W,Wu JF,Yan KL.Comparison of two methods of desquamate by PICC under the guidance of B-ultrasound combined with microinterpolation sheath technique[J].Journal of Nursing,2012,19(7B):60-62.doi:10.3969/j.issn.1008-9969.2012.14.023.
[13]陈洁红,郑立,黄木兰,等.经胸前区腋静脉穿刺行中心静脉置管患者的护理[J].南方护理学报,2005,12(5):18-19.Chen JH,Zheng L,Huang ML,et al.Nursing care of patients with central venous catheterization through axillary vein puncture in chest area[J].Nanfang Journal of Nursing,2005,12(5):18-19.doi:10.3969/j.issn.1008-9969.2005.05.007.