中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2011年
2期
119-123
,共5页
房芳%张宏岩%王峰杨武%张景莲%ZHANG Jing-lian
房芳%張宏巖%王峰楊武%張景蓮%ZHANG Jing-lian
방방%장굉암%왕봉양무%장경련%ZHANG Jing-lian
经外周静脉置入中心静脉导管%固定%导管相关并发症
經外週靜脈置入中心靜脈導管%固定%導管相關併髮癥
경외주정맥치입중심정맥도관%고정%도관상관병발증
Peripherally inserted central catheter%Catheter securement%Catheter-related complication
目的 比较3种不同的经外周静脉置人中心静脉导管(PICC)固定方法对导管固定的临床效果.方法 将120例留置PICC导管患者采用便利抽样的方法分为3组,每组各40例,分别采用缝合固定(A组)、免缝胶带交叉固定(B组)和思乐扣免缝导管固定装置固定(C组).观察并比较3组患者置管后留置期间导管固定的牢固性、并发症发生率、固定部位皮肤损伤情况及患者的满意度.结果 B组导管移位的发生率(57.5%)明显高于A组(12.5%,P=0.000)和C组(7.5%,P=0.000),导管脱出的发生率(15.0%)亦明显高于A组(0,P=0.034)和C组(0,P=0.034).导管留置期间静脉炎的发生率在B组(25.0%)明显高于A组(7.5%,P=0.034)和C组(5.0%,P=0.012);在A组中并发穿刺部位蜂窝织炎的发生率明显高于C组(20.0%比2.5%,P=0.034).A组患者出现固定翼下的皮肤压痕的发生率(37.5%)明显高于B组(5.0%,P=0.000)和C组(5.O%,P=0.000),且A组患者皮肤破损的发生率(22.5%)也高于B组(5.0%,P=0.023)和C组(0,P=0.005);各种原因所致的皮肤刺激痛在A组(52.5%)中明显增加,高于B组(0,P=0.000)和C组(2.5%,P=0.000).患者对3组不同导管固定法的满意度在A组(12.0%)显著低于B组(62.5%,P=0.000)和C组(90.0%,P=0.000),且C组满意度最高,明显高于B组(P=0.004).结论 思乐扣免缝导管固定装置固定法可以作为胶带和缝合固定的替代,具有等同于缝合法对导管的固定作用,预防了导管移位、脱出等导管相关并发症,同时也避免了缝合固定造成的皮肤损伤.
目的 比較3種不同的經外週靜脈置人中心靜脈導管(PICC)固定方法對導管固定的臨床效果.方法 將120例留置PICC導管患者採用便利抽樣的方法分為3組,每組各40例,分彆採用縫閤固定(A組)、免縫膠帶交扠固定(B組)和思樂釦免縫導管固定裝置固定(C組).觀察併比較3組患者置管後留置期間導管固定的牢固性、併髮癥髮生率、固定部位皮膚損傷情況及患者的滿意度.結果 B組導管移位的髮生率(57.5%)明顯高于A組(12.5%,P=0.000)和C組(7.5%,P=0.000),導管脫齣的髮生率(15.0%)亦明顯高于A組(0,P=0.034)和C組(0,P=0.034).導管留置期間靜脈炎的髮生率在B組(25.0%)明顯高于A組(7.5%,P=0.034)和C組(5.0%,P=0.012);在A組中併髮穿刺部位蜂窩織炎的髮生率明顯高于C組(20.0%比2.5%,P=0.034).A組患者齣現固定翼下的皮膚壓痕的髮生率(37.5%)明顯高于B組(5.0%,P=0.000)和C組(5.O%,P=0.000),且A組患者皮膚破損的髮生率(22.5%)也高于B組(5.0%,P=0.023)和C組(0,P=0.005);各種原因所緻的皮膚刺激痛在A組(52.5%)中明顯增加,高于B組(0,P=0.000)和C組(2.5%,P=0.000).患者對3組不同導管固定法的滿意度在A組(12.0%)顯著低于B組(62.5%,P=0.000)和C組(90.0%,P=0.000),且C組滿意度最高,明顯高于B組(P=0.004).結論 思樂釦免縫導管固定裝置固定法可以作為膠帶和縫閤固定的替代,具有等同于縫閤法對導管的固定作用,預防瞭導管移位、脫齣等導管相關併髮癥,同時也避免瞭縫閤固定造成的皮膚損傷.
목적 비교3충불동적경외주정맥치인중심정맥도관(PICC)고정방법대도관고정적림상효과.방법 장120례류치PICC도관환자채용편리추양적방법분위3조,매조각40례,분별채용봉합고정(A조)、면봉효대교차고정(B조)화사악구면봉도관고정장치고정(C조).관찰병비교3조환자치관후류치기간도관고정적뢰고성、병발증발생솔、고정부위피부손상정황급환자적만의도.결과 B조도관이위적발생솔(57.5%)명현고우A조(12.5%,P=0.000)화C조(7.5%,P=0.000),도관탈출적발생솔(15.0%)역명현고우A조(0,P=0.034)화C조(0,P=0.034).도관류치기간정맥염적발생솔재B조(25.0%)명현고우A조(7.5%,P=0.034)화C조(5.0%,P=0.012);재A조중병발천자부위봉와직염적발생솔명현고우C조(20.0%비2.5%,P=0.034).A조환자출현고정익하적피부압흔적발생솔(37.5%)명현고우B조(5.0%,P=0.000)화C조(5.O%,P=0.000),차A조환자피부파손적발생솔(22.5%)야고우B조(5.0%,P=0.023)화C조(0,P=0.005);각충원인소치적피부자격통재A조(52.5%)중명현증가,고우B조(0,P=0.000)화C조(2.5%,P=0.000).환자대3조불동도관고정법적만의도재A조(12.0%)현저저우B조(62.5%,P=0.000)화C조(90.0%,P=0.000),차C조만의도최고,명현고우B조(P=0.004).결론 사악구면봉도관고정장치고정법가이작위효대화봉합고정적체대,구유등동우봉합법대도관적고정작용,예방료도관이위、탈출등도관상관병발증,동시야피면료봉합고정조성적피부손상.
Objecfive To compare the clinical effectiveness of three different fixation methods for peripherally inserted central catheter(PICC).Methods Totally 120 patients requiting PICCs were randomized into suture securement group(group A),tape securement group(group B),and sutureless adhesive-hacked device (StatIock)securement group(group C),with 40 patients in each group.Patients were followed up throughout their entire catheter course,and the securement effectiveness,catheter-related complications,risk of skin injury,and patients'satisfaction were observed.Results The rate of catheter migration without function loss in group B (57.5%)was significantly higherthan in group A(12.5%,P=0.000)and in group C(7.5%,P=0.000).Catheter dislodgment rate in group B(15.0%)was also significantly higher than group A(0,P=0.034)and group C(0,JP=0.034).Phlebitis documented during their catheter course in group B(25.0%)were more than in group A(7.5%,P=0.034)and in group C(5.0%,P=0.012).In addition,the rate of cellulitis in group A was significantly higher than group C(20.0%vs.2.5%,P=0.034).The rate of skin injury in group A 0.005).Nearly half of patients in group A (52.5%)complained irritation and/or pain at the sucure site,which was significantly higher than in other two groups ( both P = 0.000 ).The patients' satisfaction rate was significantly lower in group A (12.0% ) than in the other two groups ( both P = 0.000), documented highest in group C (90.0%) (group C vs.group B, P = 0.004).Conclusions The availability of sutureless adhesive-backed de vice StatLock provides an alternative for securement of PICCs.It performs as well as suture securement in catheterfixing.Meanwhile, it can prevent catheter-related complications such as migration and dislodgment Furthermore, it avoids skin injuries during catheter fixation or securement.
