PICC专科门诊对肿瘤PICC置管患者依从性和导管自我维护能力的影响
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摘要
目的研究经外周静脉置入中心静脉导管(PICC)专科门诊对肿瘤PICC置管患者依从性和导管自我维护能力的影响。方法行PICC置管术的肿瘤患者90例,按照随机数字表法将患者分为对照组和观察组,每组45例。对照组在各病区进行PICC置管和维护,观察组在PICC专科门诊进行PICC置管和维护,比较2组PICC导管维护依从情况、PICC相关知识掌握情况及导管自我维护能力测定量表(ESCA)评分。结果观察组PICC导管维护依从率、PICC相关知识掌握达标率显著高于对照组,差异有统计学意义(P<0.05)。2组护理前ESCA评分比较差异无统计学意义(P>0.05);2组护理后ESCA评分均显著高于护理前,差异有统计学意义(P<0.05),且观察组ESCA评分高于对照组(P<0.05)。结论为肿瘤患者设立PICC专科门诊能够有效提高肿瘤PICC置管患者依从性和导管自我维护能力,值得临床推广。
Objective To investigate the effects of peripheral vein imbedding central venous catheter(PICC) special outpatient clinic on compliance and catheter self-maintenance ability of patients with tumor PICC catheterization.Methods A total of 90 tumor patients who underwent PICC in our hospital from Jun 2017 to Jun 2018 were randomly divided into observation group(n=45) and control group(n=45). The patients in control group received PICC catheterization and maintanence in PICC special outpatient clinic, however the patients in observation group received PICC catheterization and maintanence in PICC special outpatient clinic. The compliance, mastery status of PICC related knowledge and the scores of catheter self-maintenace ability measurement scale(ESCA) were observed and compared between the two groups.Results The compliance rate and control rate of PICC related knowledge in observation group were significantly higher than those in control group(P<0.05). Before nursing, there were no significant differences in ESCA scores between the two groups(P>0.05).After nursing the ESCA scores in both groups were significantly higher than those before nursing(P<0.05),moreover,which in observation group were significantly higher than those in control group(P<0.05).Conclusion The establishment of PICC special outpatient clinic can effectively improve the compliance and catheter self-maintenance ability of tumor patients with PICC catheterization, which is worthy of clinical promotion.
Objective To investigate the effects of peripheral vein imbedding central venous catheter(PICC) special outpatient clinic on compliance and catheter self-maintenance ability of patients with tumor PICC catheterization.Methods A total of 90 tumor patients who underwent PICC in our hospital from Jun 2017 to Jun 2018 were randomly divided into observation group(n=45) and control group(n=45). The patients in control group received PICC catheterization and maintanence in PICC special outpatient clinic, however the patients in observation group received PICC catheterization and maintanence in PICC special outpatient clinic. The compliance, mastery status of PICC related knowledge and the scores of catheter self-maintenace ability measurement scale(ESCA) were observed and compared between the two groups.Results The compliance rate and control rate of PICC related knowledge in observation group were significantly higher than those in control group(P<0.05). Before nursing, there were no significant differences in ESCA scores between the two groups(P>0.05).After nursing the ESCA scores in both groups were significantly higher than those before nursing(P<0.05),moreover,which in observation group were significantly higher than those in control group(P<0.05).Conclusion The establishment of PICC special outpatient clinic can effectively improve the compliance and catheter self-maintenance ability of tumor patients with PICC catheterization, which is worthy of clinical promotion.
引文
1 Lefebvre L,Noyon E,Georgescu D,et al.Port catheter versus peripherally inserted central catheter for postoperative chemotherapy in early breast cancer:a retrospective analysis of 448 patients.Supportive Care in Cancer:Official Journal of the Multinational Association of Supportive Care in Cancer,2016,24:1397-1403.
2 赵爽爽,赵瑜,李莉,等.PICC对化疗患者血浆D-二聚体水平的影响.肿瘤防治研究,2017,44:124-128.
3 程龙霞,马点玉.PICC专科护理门诊的优势及对导管维护的体会.当代护士(中旬刊),2015,23:131-132.
4 束寒玲,戴文君,张小华,等.电话回访在肿瘤患者PICC置管延续护理中的应用效果.中国护理管理,2016,16:535-539.
5 Yi XL,Chen J,Li J,et al.Risk factors associated with PICC-related upper extremity venous thrombosis in cancer patients.Journal of Clinical Nursing,2014,23:837-843.
6 Sharp R,Cummings M,Fielder A,et al.The catheter to vein ratio and rates of symptomatic venous thromboembolism in patients with aperipherally inserted central catheter(PICC):A prospective cohort study.International Journal of Nursing Studies,2015,53:677-685.
7 Marcy PY,Guiffant G,Flaud P.Catheter tip displacements at power PICC CT injection.Ajr Am J Roentgenol,2014,203:742-743.
8 李瑛珊.全程护理干预在肿瘤患者PICC管道自我维护中的应用分析.心理医生,2017,23:266-266.
9 刘琳,刘敏,张云美.PICC延续护理手册在肿瘤化疗患者中的应用效果.护理研究,2017,31:3435-3438.
10 金凤珍,温福刚.护理干预对肿瘤患者PICC置管并发症与依从性的影响分析.中国当代医药,2016,23:192-194.
11 杨莉.健康教育干预对肿瘤外科PICC置管患者依从性及自我护理能力的影响.中国现代医生,2015,53:155-157.
12 熊冬梅,田静,黄晓丹.PICC留置肿瘤患者自我护理能力及影响因素分析.实用临床医药杂志,2016,20:78-81.
13 朱秀英,石小毛,邓璀敏,等.恶性肿瘤化疗患者PICC带管期间非正常拔管的原因分析.中华现代护理杂志,2016,22:5276-5280,5281.
14 罗海兰,李雪莲.PICC专科门诊的应用效果观察.吉林医学,2016,37:2372-2374.
15 卞尧尧,杨丽丽,梅震,等.降低血液肿瘤患者PICC非计划性拔管率的品管圈实践.护理学报,2015,22:19.
16 苗娜,何丽颖,张春艳,等.PICC置管术后不良反应的分析及护理对策.吉林医学,2015,36:142.
17 李蓉梅.国内经外周静脉置入中心静脉导管专科护理门诊的发展现状.中华现代护理杂志,2010,16:2844-2845.
18 马燕,王宾艳.PDCA护理管理在老年恶性肿瘤患者PICC置管中的应用效果.中华现代护理杂志,2016,22:3961-3963,3964.
19 郭晓笛.恶性肿瘤患者应用PICC的护理效果.实用临床护理学杂志,2018,3:150-151.
20 董金莲.开设PICC护理专科门诊的实践及体会.当代护士(下旬刊),2013,21:133-134.
2 赵爽爽,赵瑜,李莉,等.PICC对化疗患者血浆D-二聚体水平的影响.肿瘤防治研究,2017,44:124-128.
3 程龙霞,马点玉.PICC专科护理门诊的优势及对导管维护的体会.当代护士(中旬刊),2015,23:131-132.
4 束寒玲,戴文君,张小华,等.电话回访在肿瘤患者PICC置管延续护理中的应用效果.中国护理管理,2016,16:535-539.
5 Yi XL,Chen J,Li J,et al.Risk factors associated with PICC-related upper extremity venous thrombosis in cancer patients.Journal of Clinical Nursing,2014,23:837-843.
6 Sharp R,Cummings M,Fielder A,et al.The catheter to vein ratio and rates of symptomatic venous thromboembolism in patients with aperipherally inserted central catheter(PICC):A prospective cohort study.International Journal of Nursing Studies,2015,53:677-685.
7 Marcy PY,Guiffant G,Flaud P.Catheter tip displacements at power PICC CT injection.Ajr Am J Roentgenol,2014,203:742-743.
8 李瑛珊.全程护理干预在肿瘤患者PICC管道自我维护中的应用分析.心理医生,2017,23:266-266.
9 刘琳,刘敏,张云美.PICC延续护理手册在肿瘤化疗患者中的应用效果.护理研究,2017,31:3435-3438.
10 金凤珍,温福刚.护理干预对肿瘤患者PICC置管并发症与依从性的影响分析.中国当代医药,2016,23:192-194.
11 杨莉.健康教育干预对肿瘤外科PICC置管患者依从性及自我护理能力的影响.中国现代医生,2015,53:155-157.
12 熊冬梅,田静,黄晓丹.PICC留置肿瘤患者自我护理能力及影响因素分析.实用临床医药杂志,2016,20:78-81.
13 朱秀英,石小毛,邓璀敏,等.恶性肿瘤化疗患者PICC带管期间非正常拔管的原因分析.中华现代护理杂志,2016,22:5276-5280,5281.
14 罗海兰,李雪莲.PICC专科门诊的应用效果观察.吉林医学,2016,37:2372-2374.
15 卞尧尧,杨丽丽,梅震,等.降低血液肿瘤患者PICC非计划性拔管率的品管圈实践.护理学报,2015,22:19.
16 苗娜,何丽颖,张春艳,等.PICC置管术后不良反应的分析及护理对策.吉林医学,2015,36:142.
17 李蓉梅.国内经外周静脉置入中心静脉导管专科护理门诊的发展现状.中华现代护理杂志,2010,16:2844-2845.
18 马燕,王宾艳.PDCA护理管理在老年恶性肿瘤患者PICC置管中的应用效果.中华现代护理杂志,2016,22:3961-3963,3964.
19 郭晓笛.恶性肿瘤患者应用PICC的护理效果.实用临床护理学杂志,2018,3:150-151.
20 董金莲.开设PICC护理专科门诊的实践及体会.当代护士(下旬刊),2013,21:133-134.