温和灸联合指摩法治疗PICC致机械性静脉炎的临床研究
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摘要
目的研究温和灸联合指摩法对外周中心静脉导管(PICC)所致机械性静脉炎的治疗作用。方法将110例经肘上静脉置入PICC后并发机械性静脉炎10 d以内的患者,随机分为两组。治疗组采用温和灸联合指摩法,在患者穿刺点往上发生静脉炎处沿穿刺静脉走行和皮肤相距1寸左右进行艾灸,使局部皮肤感温热,每次灸10～15 min。同时联合指摩法,即以喜辽妥软膏为介质,指面贴在治疗部位上,以腕部前臂作环旋摩动,每日2次,连续7 d,操作后穿刺点敷料用无菌纱布固定。如使用1～2 d后即治愈,治疗停止。对照组采用施乐辉国际医用产品公司的Ⅳ3000透明贴膜固定。在PICC导管敷贴上方先予湿热敷20 min后予喜辽妥软膏涂擦,每日2次,连续使用7 d。两组患者均观察至治疗第7日。结果两组患者采取不同措施后在治愈例数和治愈时间上差异有统计学意义(P <0.05)。治疗组治疗第2日开始VAS评分均明显低于对照组(P <0.05)。治疗组治疗结束调查问卷得分明显优于对照组(P <0.05),且治疗过程中无烫伤、感染等并发症发生。结论温和灸联合指摩法治疗PICC置管后所致的机械性静脉炎有效率高,可以大大缩短治疗静脉炎的时间,减轻患者的疼痛,缩短了治疗时间,且患者的满意度高。
Objective: To study the therapeutic effects of mild moxibustion combined with finger moxibustion on mechanical phlebitis induced by PICC. Methods: 110 patients were randomly divided into the experimental group and the control group,55 cases in each. The experimental group adopted mild moxibustion combined with finger moxibustion. If it is cured after one to two days,the treatment will stop. The control group used the IV3000 transparent sticker fixation and Hirudoid Ointment,2 times/day,7 days of continuous use. The two groups were observed for seven days from the beginning of the treatment. Results: There was significant difference in cure rate and time between the two groups after taking different measures(P < 0.05). Conclusions: Mild moxibustion combined with finger moxibustion is effective on mechanical phlebitis caused by PICC catheterization,which can greatly shorten the treatment time of phlebitis,relieve the pain of patients,and shorten the treatment time,with high satisfaction of patients.
Objective: To study the therapeutic effects of mild moxibustion combined with finger moxibustion on mechanical phlebitis induced by PICC. Methods: 110 patients were randomly divided into the experimental group and the control group,55 cases in each. The experimental group adopted mild moxibustion combined with finger moxibustion. If it is cured after one to two days,the treatment will stop. The control group used the IV3000 transparent sticker fixation and Hirudoid Ointment,2 times/day,7 days of continuous use. The two groups were observed for seven days from the beginning of the treatment. Results: There was significant difference in cure rate and time between the two groups after taking different measures(P < 0.05). Conclusions: Mild moxibustion combined with finger moxibustion is effective on mechanical phlebitis caused by PICC catheterization,which can greatly shorten the treatment time of phlebitis,relieve the pain of patients,and shorten the treatment time,with high satisfaction of patients.
引文
[1]张慧敏,刘爱玲,王辉辉,等.外周中心静脉导管技术与管理[M].北京:人民军医出版社,2013:34-36.
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[3]崔瑛.肺癌患者发生PICC置管静脉炎的危险因素及护理干预对策[J].实用临床医药杂志,2017,21(18):43-46.
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[7]王艳芳,刘彩霞,韩利清.中药外湿敷预防静脉炎的疗效观察[J].中国中医急症,2016,25(1):118-120.
[8]谢桂珠.艾灸配合金黄散贴膏外敷治疗静脉炎的效果观察[J].全科护理,2014,12(11):1027-1028.
[9]刘娟,余灵燕,王静.盐酸喜辽妥软膏在防治PICC置管后机械性静脉炎的疗效观察[J].临床合理用药杂志,2017,10(1):64-65.
[10]王秋菊.喜辽妥按摩治疗静脉炎的疗效观察[J].中国现代药物应用,2013,7(22):184.
[11]Freire AO,SugBi GC,Blanco MM,et al.Effect of moxibustion at acupoints Ben-12(Zhongwan),St-25(Tianshu),and St-36(Zuzanli)in the prevention of gastric lesions induced by indomethacin in Wistar rats[J].Digestive Diseases and Science,2005,50(2):366.
[12]李兴芳,胡萍,吴婷容.乳酸依沙吖啶溶液湿敷联合艾灸治疗盐酸胺碘酮所致静脉炎的效果观察[J].中国临床护理,2014,6(6):469-471.
[13]江丽萍,张福英,陈小丽,等.艾灸联合中药四黄散外敷治疗PICC机械性静脉炎的效果[J].中华现代护理杂志,2016,22(3):367-369.
[14]徐秀琴,王玉涛,王楠楠.艾灸治疗PICC置管后机械性静脉炎临床效果观察[J].临床药物治疗杂志,2017,15(4):71-74.
[15]罗湘.穴位按摩辅以湿敷减轻喹诺酮类药物致浅表性静脉炎的疗效观察[J].湖北中医杂志,2013,35(2):53-54.
[16]李玉琢,魏兰,薛娜娜.正红花油局部按摩治疗外周静脉留置导管后静脉炎的疗效分析[J].国际中医中药杂志,2015,37(6):509-512.
[17]戴月映.湿热敷加喜辽妥按摩在治疗新生儿PICC术后机械静脉炎的应用[J].国际护理学杂志,2016,35(22):3157-3159.
[2]詹晓雁,应灵妹,谈伟芬,等.经静脉属支泵入地塞米松溶液治疗PICC机械性静脉炎的效果[J].中华现代护理杂志,2017,23(25):3219-3222.
[3]崔瑛.肺癌患者发生PICC置管静脉炎的危险因素及护理干预对策[J].实用临床医药杂志,2017,21(18):43-46.
[4]Infusion Nurse Society.Infusion nursing standards of practice[J].J Infus Nurs,2000,23(6s):S1-S8.
[5]Uslusoy E.and S.Mete,Predisposing factors to phlebitis in patients with peripheral intravenous catheters:a descriptive study[J].J Am Acad Nurse Pract,2008,20(4):172-180.
[6]Groll D,Davies B,MacDonald J,et al.Evaluation of the psychometric properties of the phlebitis and infiltration scales for the assessment of complications of peripheral vascular access devices[J].J Infus Nurs,2010,33(6):385-390.
[7]王艳芳,刘彩霞,韩利清.中药外湿敷预防静脉炎的疗效观察[J].中国中医急症,2016,25(1):118-120.
[8]谢桂珠.艾灸配合金黄散贴膏外敷治疗静脉炎的效果观察[J].全科护理,2014,12(11):1027-1028.
[9]刘娟,余灵燕,王静.盐酸喜辽妥软膏在防治PICC置管后机械性静脉炎的疗效观察[J].临床合理用药杂志,2017,10(1):64-65.
[10]王秋菊.喜辽妥按摩治疗静脉炎的疗效观察[J].中国现代药物应用,2013,7(22):184.
[11]Freire AO,SugBi GC,Blanco MM,et al.Effect of moxibustion at acupoints Ben-12(Zhongwan),St-25(Tianshu),and St-36(Zuzanli)in the prevention of gastric lesions induced by indomethacin in Wistar rats[J].Digestive Diseases and Science,2005,50(2):366.
[12]李兴芳,胡萍,吴婷容.乳酸依沙吖啶溶液湿敷联合艾灸治疗盐酸胺碘酮所致静脉炎的效果观察[J].中国临床护理,2014,6(6):469-471.
[13]江丽萍,张福英,陈小丽,等.艾灸联合中药四黄散外敷治疗PICC机械性静脉炎的效果[J].中华现代护理杂志,2016,22(3):367-369.
[14]徐秀琴,王玉涛,王楠楠.艾灸治疗PICC置管后机械性静脉炎临床效果观察[J].临床药物治疗杂志,2017,15(4):71-74.
[15]罗湘.穴位按摩辅以湿敷减轻喹诺酮类药物致浅表性静脉炎的疗效观察[J].湖北中医杂志,2013,35(2):53-54.
[16]李玉琢,魏兰,薛娜娜.正红花油局部按摩治疗外周静脉留置导管后静脉炎的疗效分析[J].国际中医中药杂志,2015,37(6):509-512.
[17]戴月映.湿热敷加喜辽妥按摩在治疗新生儿PICC术后机械静脉炎的应用[J].国际护理学杂志,2016,35(22):3157-3159.