CAJ | 학술논문

目的分析经外周植入中心静脉导管(PICC)非计划性拔管的原因并探讨其预防措施.方法回顾性总结2005年7月～2008年6月432例PICC导管维护中的经验和教训,分析26例非计划性拔管的不同原因.结果出现导管堵塞、导管异位或移位、导管脱出、导管相关性感染、机械性静脉炎以及血栓形成等并发症是造成非计划性拔管的主要原因,而这些并发症主要与导管材质差、固定不妥、导管尖端位置未达上腔静脉、离院患者管理缺陷及意外或其他情况有关.结论选用硅胶材质导管、保证导管尖端位置达到上腔静脉、护士对患者离院期间的联络和管理是预防非计划性拔管的有效措施.
목적분석경외주식입중심정맥도관(PICC)비계화성발관적원인병탐토기예방조시.방법 회고성총결2005년7월～2008년6월432례PICC도관유호중적경험화교훈,분석26례비계화성발관적불동원인.결과 출현도관도새、도관이위혹이위、도관탈출、도관상관성감염、궤계성정맥염이급혈전형성등병발증시조성비계화성발관적주요원인,이저사병발증주요여도관재질차、고정불타、도관첨단위치미체상강정맥、리원환자관리결함급의외혹기타정황유관.결론 선용규효재질도관、보증도관첨단위치체도상강정맥、호사대환자리원기간적련락화관리시예방비계화성발관적유효조시.
Objective To analyze the reasons of non-planned decannulation (NPD) of peripheraly inserted central catheter (PICC) and explore the applicable prevention strategies.Methods We retrospectively analyzed the clinical data of 432 patients who underwent PICC cannulations maintenance between July 2005 and June 2008.The reasons of 26 cases of NPD were analyzed.Results The main reasons of NPD included cannulation occlusion,cannulation ectopia or translocation,cannulation exfoliation,cannulation-related infections,mechanical phlebitis,and thrombus formation.The complications usually were caused by the poor cannulation material,incorrect fixation,top of canuulation not reaching superior vena cava,lack of management measures for outpatients,accidents,and others.Effective measures for preventing NPD included:use silica gel cannulation;ensure the top of canuulation reach the superior vena cava;and improve the communications between outpatients and nurses.Conclusion NPD of PICC may be caused by various reasons and effective prevention measures should be taken.