PDCA护理管理对降低血液透析患者中心静脉导管相关并发症的影响
摘要
目的探索PDCA管理方法对中心静脉导管相关并发症的作用与效果,以期为临床护理提供参考。方法选取2016年1-12月和2017年1-12月使用中心静脉导管进行维持性血液透析治疗的慢性肾衰竭患者74例患者分别作为对照组和观察组,每组37例,观察组应用PDCA管理方法进行护理,比较2组中心静脉导管感染率、导管功能不良发生率、导管渗血率及导管断裂发生率。结果 2组患者中心静脉导管感染率、导管功能不良发生率和导管渗血率比较,差异有统计学意义(P<0.05)。2组患者导管断裂发生率比较,差异无统计学意义(χ~2=1.000,P=0.317)。结论应用PDCA管理方法可以降低MHD患者中心静脉导管并发症,值得在临床护理工作中推广。
引文
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[2]孙雪峰.血液透析中心静脉导管如何合理抗凝[J].中国血液净化,2015,14(1):13-17.
[3]LI HM.Report:distribution and clinical characteristics of pathogenic bacteria causing catheter-related bloodstream infections[J].Pak J Pharm Sci,2015,28(Suppl 3):S1163-1166.
[4]TAYLOR G,GRAVEL D,JOHNSTON L,et al.Incidence of bloodstream infection in multicenter inception cohorts of hemodialysis patients[J].Am J Infect Control,2004,32(3):155-160.
[5]蔡宗仰,欧阳梓华,禤伟振,等.血液透析患者血管通路感染[J].肾脏病与透析肾移植杂志,2012,21(2):145-147.
[6]黎利娟,李燕飞,韦艳琴.血液透析患者中心静脉导管相关性血行感染的预防及护理进展[J].当代护士:下旬刊,2016(7):6-8.
[7]李争艳,刘敏,窦艳娜,等.血液透析临时中心静脉置管术后患者舒适状况的调查研究[J].重庆医学,2017,46(15):2131-2134.
[8]GARCíA CORTES MJ,VIEDMA G,SANCHEZ PERALES MC,et al.Fistulae or catheter for elderly who start hemodialysis without permanent vascular access?[J].Nefrologia,2005,25(3):307-314.
[9]MORAN J,SUN S,KHABABA I,et al.A randomized trial comparing gentamicin/citrate and heparin locks for central venous catheters in maintenance hemodialysis patients[J].Am J Kidney Dis,2012,59(1):102-107.
[10]CHUA HR,SCHNEIDER AG,SHERRY NL,et al.Initial and extended use of femoral versus nonfemoral double-lumen vascular catheters and catheter-related infection during continuous renal replacement therapy[J].Am J Kidney Dis,2014,64(6):909-917.
[11]CHEN WT,HUANG HR,LIM KP,et al.The correlation between seasonality and peripherally inserted central catheter-related infections in cancer patients[J].J Infect,2015,71(3):410-412.
[12]崔琳琳,叶朝阳.中心静脉长期留置导管常用封管液及封管方法[J].中国血液净化,2015,14(1):5-9.
[13]谢爱华,曾庆飞.1例血液透析患者长期留置导管发生破裂的护理[J].护理学报,2014,21(13):25-26.