肿瘤患者治疗期PICC堵管相关因素分析与护理对策
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摘要
目的探讨肿瘤患者治疗期间PICC堵管的发生情况及相关影响因素。方法回顾性分析本院2014年1—12月应用PICC治疗的1 391例肿瘤患者住院治疗期间的临床资料,进行多因素分析探讨影响PICC堵管的相关因素。结果 1 391例肿瘤患者发生PICC堵管共37例(2.7%)。多因素分析结果显示,合并有2种以上慢性疾病、未及时冲管、封管、咳嗽、导管尖端位置为肿瘤患者PICC堵管的影响因素(P<0.05)。结论肿瘤患者治疗期间PICC堵管并发症需得到重视,应针对堵管高风险患者进行针对性预防护理,做到早发现、早处理,从而延长PICC留置时间。
Objective To explore the influence factors of PICC catheter blockage of cancer patients during treatment period.Methods A retrospective analysis was conducted for clinical materials of 1,391 hospitalized cancer patients with PICC catheter and multi-factor analysis was carried out for factors exerting influence on PICC catheter blockage.Results Thirty-seven cases of PICC catheter blockage occurred,with an incidence of 2.7% and multi-factor analysis indicated that two or more chronic diseases,without timely catheter washing and sealing,cough,tip of CIPP catheter were the influence factors of PICC catheter blockage(P <0.05).Conclusion Great importance should be attached to PICC catheter blockage-induced complications and targeted nursing will prolong the indwelling of PICC.
Objective To explore the influence factors of PICC catheter blockage of cancer patients during treatment period.Methods A retrospective analysis was conducted for clinical materials of 1,391 hospitalized cancer patients with PICC catheter and multi-factor analysis was carried out for factors exerting influence on PICC catheter blockage.Results Thirty-seven cases of PICC catheter blockage occurred,with an incidence of 2.7% and multi-factor analysis indicated that two or more chronic diseases,without timely catheter washing and sealing,cough,tip of CIPP catheter were the influence factors of PICC catheter blockage(P <0.05).Conclusion Great importance should be attached to PICC catheter blockage-induced complications and targeted nursing will prolong the indwelling of PICC.
引文
[1]吴娟,顾冬梅.PICC导管堵管的因素及应对策略的研究现状[J].护理学报,2012,19(2A):18-20.
[2]彭易,王岚,邹静.肝素稀释液预防成年患者PICC堵塞的Meta分析[J].护理学报,2014,21(4):24-28.
[3]蒋朱明,蔡威.临床肠外与肠内营养[M].北京:科学技术文献出版社,2000:281.
[4]郑保义.世界卫生组织关于吸烟行为调查的基本原则[J].中国健康教育杂志,1992,8(5):2-6.
[5]刘扬帆,高建步.参芪扶正注射液联合多西他赛治疗中晚期非小细胞肺癌[J].中国实验方剂学杂志,2011,17(5):231-232.
[6]王建荣.输液治疗护理实践指南与实施细则[M].北京:人民军医出版社,2009:115-117.
[7]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013版)[J].中华糖尿病杂志,2014,6(7):447-498.
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[11]乔爱珍,李新华,董淑华,等.骨髓移植患者锁骨下静脉置管内壁沉积物的观察[J].中华护理杂志,2003,38(8):631-633.
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[13]刘伟.血液高凝状态的研究进展[J].医学研究杂志,2007,36(4):103-106.
[14]郑春辉.经外周穿刺置人中心静脉导管的并发症及防治[J].中华护理杂志,2004,39(9):700-701.
[15]贾葵,莫少新,陆利生.86例胃癌术后颈内静脉置管预防导管内血栓形成的护理[J].中国癌症防治杂志,2012,4(1):75-77.
[16]金静芬,陈春芳,赵锐秭,等.经外周穿刺置人中心静脉导管异位处理方法的研究进展[J].中华护理杂志,2013,48(2):184-187.
[17]蒋丽,曾奕华,曹晓琳,等.根本原因分析法预防极重症伴多发静脉血栓患者中心静脉导管再堵管的效果观察[J].护士进修杂志,2014,29(23):2162-2164.
[18]贾葵,莫少新,陆利生.86例胃癌术后颈内静脉置管预防导管内血栓形成的护理[J].中国癌症防治杂志,2012,4(1):75-77.DOI:10.3969/j.issn.1674-5671.2012.01.19.
[19]仝笛,袁玲,丁亚萍.PICC血栓性堵管相关因素及其应对策略的研究进展[J].解放军护理杂志,2013,30(24):36-38.
[20]张妮娜,何涛.高血压与下肢深静脉血栓形成相关性的病例对照研究[J].包头医学院学报,2014,30(2):49-51.
[21]Hermanides J,Cohn D M,Devries J H,et al.Venous Thrombosis Is Associated with Hyperglycemia at Diagnosis:A Case Control Study[J].J Thromb Haemost 2009,7(6):945-949.DOI:10.1111/j.1538-7836.2009.03442.x.
[22]Andrew A w,Marc Carrier,Joshua Koczerginski.Incidence and Predictive Factors of Symptomatic Thrombosis Related to Peripherally Inserted Central Catheters in Chemotherapy Patients[J].Thromb Res,2012,130(3):323-326.DOI:10.1016/j.thromres.2012.02.048.
[2]彭易,王岚,邹静.肝素稀释液预防成年患者PICC堵塞的Meta分析[J].护理学报,2014,21(4):24-28.
[3]蒋朱明,蔡威.临床肠外与肠内营养[M].北京:科学技术文献出版社,2000:281.
[4]郑保义.世界卫生组织关于吸烟行为调查的基本原则[J].中国健康教育杂志,1992,8(5):2-6.
[5]刘扬帆,高建步.参芪扶正注射液联合多西他赛治疗中晚期非小细胞肺癌[J].中国实验方剂学杂志,2011,17(5):231-232.
[6]王建荣.输液治疗护理实践指南与实施细则[M].北京:人民军医出版社,2009:115-117.
[7]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013版)[J].中华糖尿病杂志,2014,6(7):447-498.
[8]中华人民共和国卫生和计划生育委员会.冠状动脉粥样硬化性心脏病诊断标准(WS 319-2010)[M].北京:中国标准出版社,2010:1-14.
[9]中国高血压基层管理指南修订委员会.中国高血压基层管理指南[J].临床荟萃,2015,30(7):725-744.
[10]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版)[J].中华结核和呼吸杂志,2013,36(4):255-264.
[11]乔爱珍,李新华,董淑华,等.骨髓移植患者锁骨下静脉置管内壁沉积物的观察[J].中华护理杂志,2003,38(8):631-633.
[12]刘琼玲,高竹林.PICC治疗间歇期堵管原因分析及防治对策[J].护理学报,2012,19(23):54-56.
[13]刘伟.血液高凝状态的研究进展[J].医学研究杂志,2007,36(4):103-106.
[14]郑春辉.经外周穿刺置人中心静脉导管的并发症及防治[J].中华护理杂志,2004,39(9):700-701.
[15]贾葵,莫少新,陆利生.86例胃癌术后颈内静脉置管预防导管内血栓形成的护理[J].中国癌症防治杂志,2012,4(1):75-77.
[16]金静芬,陈春芳,赵锐秭,等.经外周穿刺置人中心静脉导管异位处理方法的研究进展[J].中华护理杂志,2013,48(2):184-187.
[17]蒋丽,曾奕华,曹晓琳,等.根本原因分析法预防极重症伴多发静脉血栓患者中心静脉导管再堵管的效果观察[J].护士进修杂志,2014,29(23):2162-2164.
[18]贾葵,莫少新,陆利生.86例胃癌术后颈内静脉置管预防导管内血栓形成的护理[J].中国癌症防治杂志,2012,4(1):75-77.DOI:10.3969/j.issn.1674-5671.2012.01.19.
[19]仝笛,袁玲,丁亚萍.PICC血栓性堵管相关因素及其应对策略的研究进展[J].解放军护理杂志,2013,30(24):36-38.
[20]张妮娜,何涛.高血压与下肢深静脉血栓形成相关性的病例对照研究[J].包头医学院学报,2014,30(2):49-51.
[21]Hermanides J,Cohn D M,Devries J H,et al.Venous Thrombosis Is Associated with Hyperglycemia at Diagnosis:A Case Control Study[J].J Thromb Haemost 2009,7(6):945-949.DOI:10.1111/j.1538-7836.2009.03442.x.
[22]Andrew A w,Marc Carrier,Joshua Koczerginski.Incidence and Predictive Factors of Symptomatic Thrombosis Related to Peripherally Inserted Central Catheters in Chemotherapy Patients[J].Thromb Res,2012,130(3):323-326.DOI:10.1016/j.thromres.2012.02.048.