ICU非计划性拔管的特征分析及对策.doc

综合护理干预对肿瘤患者PICC并发症的影响 郑 艳，赵敏丽，蒋 恽，朱 燕，邵文娟，施浩婷，张爱萍 （宁波市鄞州第二医院，浙江 宁波 315100） [摘　要] 目的 评估综合性干预措施对成人肿瘤患者PICC并发症的预防作用。方法 对观察组107例肿瘤PICC患者实施综合干预措施，即将护理再教育作为科室的持续质量改进项目,在置管后给予多磺酸粘多糖乳膏外涂、X线辅助导管定位、最大化消毒屏障管理等，与本科室既往129例肿瘤患者的PICC并发症进行比较。结果 ⑴对照组和观察组PICC并发症总发生率分别为40.3%和11.2%，差异有统计学意义(χ2＝25.051，P＜0.01)，观察组的机械性静脉炎、导管堵塞和导管异位发生率明显低于对照组(P＜0.05)。Impact of Multifaceted Interventions on Complications of Peripherally Inserted Central Catheter in Oncology Patients* ZHENG Yan, ZHAO Min-li, JIANG Hui, ZHU Yan, SHAO Wen-juan, SHI Hao-ting, ZHANG Ai-ping (The Second Hospital of Yinzhou County, Ningbo 315100, China) Corresponding author: ZHANG Ai-ping, Email: zhangaiping100@yahoo.cn 【Abstract】Objective To evaluate the efficacy of multifaceted interventions in reducing complications of peripherally inserted central venous catheter (PICC) in adult oncology patients. Methods The control subjects who were not received multifaceted interventions were collected from January to June in 2006 in our department. Multifaceted interventions were implemented in observational group from July to October in 2006. These interventions include: nurse reeducation, X-ray guided reposition, early use of mucopolysaccharide polysulfate cream, maintenance of maximum sterile barrier precaution, etc. The complication rates of PICC were compared between the two groups. Results ⑴Compared with the controls, the observational group was associated with a 72.2% decrease in the overall complication rate (11.2% vs 40.3%, χ2＝25.051, P＜0.01). ⑵The complication rates of phlebitis, occlusion, malposition, thrombosis, accidental dislodgement and PICC associated infection were 15.5%(20/129), 10.8%(14/129), 7.7%(10/129), 2.3%(3/129), 2.3%(3/129), 1.6%(2/129) in the control group, and 4.7%(5/107), 1.9%(2/107), 1.9%(2/107), 0.9%(1/107), 0.9%(1/107), 0.9%(1/107) in the observational group. The complication rates of phlebitis, occlusion and malposition differed significantly between the two groups. Conclusion The results suggest