乳腺癌患者置PICC延续护理.docVIP

乳腺癌患者置PICC延续护理【摘要】 目的 总结乳腺癌经PICC化疗住院期间及出院后PICC维护的延续护理模式及运行效果。方法 培训护士,规范PICC维护操作,住院期间分阶段重复多次进行健康教育,重视出院阶段的健康教育,实行护理组长负责制,建立带PICC离院患者档案,定期电话访谈,病区仍为出院患者提供24 h 的PICC维护和电话咨询服务。结果 形成了医院与家庭、护士与患者之间的互动,为经PICC化疗的乳腺癌患者提供及时、便利、连续、全程的PICC维护服务;患者的PICC维护依从性达到100%,护理满意度达到100%。结论 该模式取得了预期的良好效果,值得推广。 【关键词】乳腺癌;PICC;延续护理 The continuing nursing of PICC for breast cancer patients LIN Jia-xuan,ZHANG Hui-ling,LI Xiao-ling,et al.Breast Disease Center,the third affiliated hospital of Sun Yat-Sen University,Guangzhou 510630,China 【Abstract】 Objective This paper introduces the development and implementation of PICC continuing nursing mode for breast cancer patients when they are in the hospital or leave the hospital.Methods In this mode,all the nurses were trained to well attend PICC and manifested standard procedures of PICC continuing nursing.All patients received repeated health educations in different grading as well as they left hospital.Nursingteamleaders were responsible for the continuing nursing.We would recommend files for patients leaving hospital with PICC,also supply 24 hr service of PICC continuing nursing and telephone consultation for them.Results The continuing nursing mode between family and hospital as well as patients and nurses was formed to provide timely,convenient,continuous and whole-process nursing care for breast cancer patients with PICC.The compliance of PICC continuing nursing was 100%,and the patient satisfaction rate was 100%.Conclusion The implementation of the continuing nursing mode achieved good effect and was approved by the patients. 【Key words】Breast cancer; PICC; Continuing nursing 乳腺癌患者术后静脉输液一般禁用患侧上肢静脉,下肢静脉易于栓塞也不宜采用,往往只有健侧上肢静脉可供选用。乳腺癌患者化疗往往联合用药,大约6~8个疗程,每个疗程隔3周,化疗结束一般需3~6个月,且化疗药物对血管刺激性大,长期一侧上肢外周静脉穿刺化疗,常引起血管损伤,发生静脉炎,甚至局部组织坏死,影响化疗的顺利进行。为了保护血管和保证化疗顺利完成,有很多患者选择经外周静脉留置中心静脉导管(PeripherallyInserted Central Catheters,简称PICC)化疗。如果PICC维护不当,可能会因为感染、导管脱出、导管堵塞、皮肤过敏、血栓形成等并发症的发生而非正常拔管[1],或出院后维护不便而不得不选择拔管[1],从而丧失了留置PICC的意义,影响了化疗的顺利进行;而且留置PICC的乳腺癌患者除了化