【doc】PICC置管患者导管断裂的护理干预.doc

PICC置管患者导管断裂的护理干预 护理学杂志2011年9月第26卷第17期(综合版) PICC置管患者导管断裂的护理干预 王颖 ? 57? 摘要:目的探讨PICC置管患者导管断裂的处理方法及护理措施.方法对1O例导管体外部分断裂患者采取修复导管,对1例导 管断裂体内患者经静脉切开术取出断端导管.结果10例导管体外部分断裂患者通过导管修复后继续使用,未出现导管修复后 相关性并发症,患者均按计划完成全部化疗疗程后顺利拔除PICC.1例经静脉切开术取出断端导管患者,术后血管恢复良好,术 后第12天复诊行切口拆线,伤口愈合良好,未出现出血,感染等并发症.结论及时发现,正确处理断裂导管,同时增强护理人员 防范意识,正确维护导管,规范操作,加强患者健康教育,可减少和预防PICC断裂并发症的发生. 关键词:经外周静脉置入中心静脉导管(PICC);导管断裂;导管修复;护理 中图分类号:R472文献标识码:A文章编号:1001—4152(2011)17—0057—03DOI:10.3870/hlxzz.2011.17.057 NursinginterventionsofpatientswithPICCtuberupturef}WangYingfSurgicalDepartmentofThyroidandBreast,TongJi Hospital,TongJiMedicalCollege,HuazhongUniversityofScienceandTechnology,Wuhan430030,China) Abstract:ObjectiveToexplorethemanagementandnursinginterventionsforpatientswithPICCtuberupture.MethodsAtotalof 10caseshadtheinvitropartofPICCsruptured.Werepairedtherupturedtubesforthem.Asforonecasewhohadtheinvivo partofthePICCfractured,venesectionwasappliedtoherandtheinvivobroken梠fftipofthePICCwasremoved.ResultsNorele?vantcomplicationsweredetectedinthetencaseswiththeinvitropartofPICCsruptured.A1lthesepatientsenjoyedsuccessful PICCremovalaftercompletionofallchemotherapyaccordingtotreatmentplan.Whenitcametothecasewithinvivofractured PICC,thestichedbloodvesselafterbeingcutopenwasabletofunctionproperly.Twelvedayslater,thestitchesofthebloodYeS?selwereremoved,andthewoundhealedcompletelywithoutcomplicationsofhemorrhageorinfection.ConclusionItisadvisableto advocatetimelydetectionandcorrecthandlingoffracturedorrupturedPICC.Moreover,nursesshouldenhancepersonalawareness ofprevention,protectthecathetercorrectly,standardizenursingpracticeandreinforcehealtheducationforpatients.Onlyinthese wayscanwereduceandpreventincidenceofPICCtuberupture. Keywords:peripherallyinsertedcentralcatheter(PICC);PICCtuberupture;catheterrepair;nursingcare 经外周静脉置人中心静脉导管(PeripherallyIn- sertedCentralCatheter,PICC)置管是采用引导针将 一 根由硅胶材料制成的标有刻度,能放射显影的中心 静脉导管经外周静脉置人,使其顶端位于上腔静脉内 的导管植入术.该技术不受年龄,性别,疾病种类的 限制,只需外周穿刺,置管操作简单,创伤小,成功率 高,留置时间长,已广泛用于肿瘤化疗,肠外营养,长 期静脉输液等患者[1].尽管P