耐高压双腔PICC导管不同外露长度对患者的影响
|
摘要
目的探讨耐高压双腔型经外周静脉穿刺置入中心静脉导管(PICC)不同外露长度对患者疼痛、出血量以及舒适度的影响。方法选取置入耐高压双腔PICC导管患者121例,分为试验组59例和对照组54例(脱落8例)。对照组耐高压双腔PICC导管按照常规全部送入体内,试验组耐高压双腔PICC导管的患者保留外露长度2 cm。比较2组患者置管后24 h、48 h、3 d、1周、4周疼痛程度,观察患者穿刺点出血情况以及患者的舒适度。结果置管后24 h、48 h,试验组患者的疼痛评分低于对照组,差异均有统计学意义(P<0.05)。置管后24 h、48 h,试验组患者局部出血量高于对照组,差异有统计学意义(P<0.05)。置管后3 d、1周、4周试验组舒适度视觉模拟评分(VAS)高于对照组,差异有统计学意义(P<0.01)。结论耐高压双腔PICC导管外露2 cm能降低患者置管后48 h内的疼痛,提高患者远期舒适度,值得推广应用。
Objective To investigate the effect of pressure-resistant double-lumen peripherally inserted central catheterization(PICC) with different external length on pain, subcutaneous hemorrhage and comfort level of patients. Methods Totally 121 patients undergoing pressure-resistant double-lumen PICC catheterization were assigned to the study group(n=59) and the control group(n=54, and 8 lost to follow-up). The pressure-resistant double-lumen PICC line was entirely inserted into the body in the control group. In the study group, the PICC line was placed with external length of 2 cm. The pain degree at puncture site at 24 hours, 48 hours, 3 day, 1 week and 4 weeks after catheter placement was evaluated. The subcutaneous hemorrhage and comfort level of patients were evaluated and compared between two groups. Results The scores of pain intensity in the study group were lower than those in the control group at 24 hours and 48 hours after catheter placement(P<0.05). The subcutaneous hemorrhage was more severe in the study group than that in the control group at 24 hours and 48 hours after catheter placement(P<0.05). The scores of Visual analogue Scale(VAS) on comfort degree were higher in the study group than those in the control group at 3 day, 1 week and 4 weeks after catheter placement(P<0.01). Conclusion The placement methods with external length of 2 cm can reduce the pain intensity within 48 hours after PICC placement, and improve the long-term comfort of patients.
Objective To investigate the effect of pressure-resistant double-lumen peripherally inserted central catheterization(PICC) with different external length on pain, subcutaneous hemorrhage and comfort level of patients. Methods Totally 121 patients undergoing pressure-resistant double-lumen PICC catheterization were assigned to the study group(n=59) and the control group(n=54, and 8 lost to follow-up). The pressure-resistant double-lumen PICC line was entirely inserted into the body in the control group. In the study group, the PICC line was placed with external length of 2 cm. The pain degree at puncture site at 24 hours, 48 hours, 3 day, 1 week and 4 weeks after catheter placement was evaluated. The subcutaneous hemorrhage and comfort level of patients were evaluated and compared between two groups. Results The scores of pain intensity in the study group were lower than those in the control group at 24 hours and 48 hours after catheter placement(P<0.05). The subcutaneous hemorrhage was more severe in the study group than that in the control group at 24 hours and 48 hours after catheter placement(P<0.05). The scores of Visual analogue Scale(VAS) on comfort degree were higher in the study group than those in the control group at 3 day, 1 week and 4 weeks after catheter placement(P<0.01). Conclusion The placement methods with external length of 2 cm can reduce the pain intensity within 48 hours after PICC placement, and improve the long-term comfort of patients.
引文
[1] 严云丽,左杰,孙学珍,等.耐高压注射型PICC导管的临床应用及护理[J].中华护理杂志,2012,47(2):158-159.
[2] 金向红,赵林芳.耐高压注射型PICC推注造影剂的临床应用经验[J].中华临床营养杂志,2012,20(1):52-53.
[3] BAIOCCO G G,DA SILVA J L B.The use of the peripherally inserted central catheter (picc) in the hospital environment[J].Rev Latino-Am Enfermagem,2010,18(6):1131-1137.
[4] 吴婉英,杨方英,高利琴,等.耐高压注射型双腔PICC导管在肿瘤患者中的应用[J].护士进修杂志,2013,28(15):1411-1413.
[5] FREY A M,SCHEARS G J.Why are we stuck on tape and suture?[J].Journal Infus Nurs,2006,29(1):34-38.
[6] 龚振琴,姚轶男,孙敏,等.IV3000透气敷料应用于PICC置管后的效果观察[J].护理研究,2011,25(9):797-798.
[7] 王海芳,孟华,杨益群.苏州市静脉治疗护理临床实践指南[M].苏州:苏州大学出版社,2015.
[8] 韩荟,聂良华,唐月红,等.钝性分离法在PICC置管术中的应用[J].中西医结合护理(中英文),2017,3(6):102-104.
[9] 高月英,申蕊娟,苏琳.《静脉治疗护理技术操作规范》的解读与临床实践[J].护理研究,2014(33):4179-4180.
[10] 周庆梅,李蓉梅.双腔耐高压 PICC 导管的护理研究进展[J].全科护理,2015,13(24):2364-2365.
[11] 韩娟,任晓琼,王金霞,等.双腔耐高压PICC使用方法的改进[J].护理学杂志,2015,30(17):39-40.
[12] 殷荣华,汪生梅,蔡义红,等.量化PICC功能锻炼操在PICC置管病人中的应用[J].护理研究,2017,31(29):3712-3714.
[13] 朱亚,董芳,何俏梅,等.应用循证护理规范PICC置管操作的实践[J].解放军护理杂志,2009,26(21):40-42.
[14] 高东霞.PICC尖端定位及移位的研究进展[J].护理学杂志,2015,30(7):110-113.
[15] 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(14):60-62.
[16] 王曙红,蒋冬梅,周建辉,等.机械通气患者舒适度与医务人员认知状况比较[J].中国实用护理杂志,2007,23(28):58-59.
[17] 赵爱琳,张瑜.纽扣式血透压脉带联合明胶海绵在耐高压双腔PICC止血中的应用[J].护理学杂志,2014,29(4):51-52.
[2] 金向红,赵林芳.耐高压注射型PICC推注造影剂的临床应用经验[J].中华临床营养杂志,2012,20(1):52-53.
[3] BAIOCCO G G,DA SILVA J L B.The use of the peripherally inserted central catheter (picc) in the hospital environment[J].Rev Latino-Am Enfermagem,2010,18(6):1131-1137.
[4] 吴婉英,杨方英,高利琴,等.耐高压注射型双腔PICC导管在肿瘤患者中的应用[J].护士进修杂志,2013,28(15):1411-1413.
[5] FREY A M,SCHEARS G J.Why are we stuck on tape and suture?[J].Journal Infus Nurs,2006,29(1):34-38.
[6] 龚振琴,姚轶男,孙敏,等.IV3000透气敷料应用于PICC置管后的效果观察[J].护理研究,2011,25(9):797-798.
[7] 王海芳,孟华,杨益群.苏州市静脉治疗护理临床实践指南[M].苏州:苏州大学出版社,2015.
[8] 韩荟,聂良华,唐月红,等.钝性分离法在PICC置管术中的应用[J].中西医结合护理(中英文),2017,3(6):102-104.
[9] 高月英,申蕊娟,苏琳.《静脉治疗护理技术操作规范》的解读与临床实践[J].护理研究,2014(33):4179-4180.
[10] 周庆梅,李蓉梅.双腔耐高压 PICC 导管的护理研究进展[J].全科护理,2015,13(24):2364-2365.
[11] 韩娟,任晓琼,王金霞,等.双腔耐高压PICC使用方法的改进[J].护理学杂志,2015,30(17):39-40.
[12] 殷荣华,汪生梅,蔡义红,等.量化PICC功能锻炼操在PICC置管病人中的应用[J].护理研究,2017,31(29):3712-3714.
[13] 朱亚,董芳,何俏梅,等.应用循证护理规范PICC置管操作的实践[J].解放军护理杂志,2009,26(21):40-42.
[14] 高东霞.PICC尖端定位及移位的研究进展[J].护理学杂志,2015,30(7):110-113.
[15] 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(14):60-62.
[16] 王曙红,蒋冬梅,周建辉,等.机械通气患者舒适度与医务人员认知状况比较[J].中国实用护理杂志,2007,23(28):58-59.
[17] 赵爱琳,张瑜.纽扣式血透压脉带联合明胶海绵在耐高压双腔PICC止血中的应用[J].护理学杂志,2014,29(4):51-52.