CAJ | 학술논문

目的：探讨肿瘤化疗患者PICC 不同固定方式的临床效果。方法选择本院2009年6月-2012年6月首次化疗患者90例采用抛硬币方法随机分成观察组和对照组各45例，观察组采用顺穿刺血管方向摆放法固定，对照组采用传统“S”形摆放法固定。治疗期间观察记录导管的破损情况及导管相关性并发症的发生情况并询问两组患者的满意度和舒适度。结果观察组导管破裂率为4．4％（2/45），低于对照组的20．0％（9/45），差异有统计学意义（χ2＝5．075，P＜0．05）。观察组发生局部渗血1例，明显少于对照组的9例，差异有统计学意义（χ2＝7．200，P＜0．01）；而两组患者发生静脉炎、导管相关性感染、导管阻塞、导管脱出并发症情况比较，差异无统计学意义（P＞0．05）。观察组患者满意度和舒适度评分为（1．02±0．27），（1．32±0．61）分，均低于对照组的（2．16±0．35），（2．45±0．67）分，差异有统计学意义（ t分别为1．173，1．528；P＜0．05）。结论采用顺穿刺血管方向摆放法固定方式，可以减少PICC应用维护过程中的局部渗血，同时可以预防PICC导管破裂和增加患者对PICC的满意度和舒服度。
목적：탐토종류화료환자PICC 불동고정방식적림상효과。방법선택본원2009년6월-2012년6월수차화료환자90례채용포경폐방법수궤분성관찰조화대조조각45례，관찰조채용순천자혈관방향파방법고정，대조조채용전통“S”형파방법고정。치료기간관찰기록도관적파손정황급도관상관성병발증적발생정황병순문량조환자적만의도화서괄도。결과관찰조도관파렬솔위4．4％（2/45），저우대조조적20．0％（9/45），차이유통계학의의（χ2＝5．075，P＜0．05）。관찰조발생국부삼혈1례，명현소우대조조적9례，차이유통계학의의（χ2＝7．200，P＜0．01）；이량조환자발생정맥염、도관상관성감염、도관조새、도관탈출병발증정황비교，차이무통계학의의（P＞0．05）。관찰조환자만의도화서괄도평분위（1．02±0．27），（1．32±0．61）분，균저우대조조적（2．16±0．35），（2．45±0．67）분，차이유통계학의의（ t분별위1．173，1．528；P＜0．05）。결론채용순천자혈관방향파방법고정방식，가이감소PICC응용유호과정중적국부삼혈，동시가이예방PICC도관파렬화증가환자대PICC적만의도화서복도。
Objective To investigate the clinical effect of different fixed way of tumor chemotherapy patients with PICC .Methods Totals of 90 patients during June 2009 to June 2012 were randomly divided into experimental group and control group , with 45 cases in each group .Experimental group used the puncture vascular direction fixing way ,while control group used the “S” shape traditional fixed method .The breakage of catheter, catheter-related complications, patients ’ satisfaction and comfort of two groups were observed . Results In experimental group , catheter fracture rate was significantly lower than that in control group , and the difference was statistically significant (4.4% vs 20.0%, χ2 =5.075, P=0.024).Local bleeding occurred cases in experimental group were significantly less than that in control group (1 vs 9,χ2 =7.200,P=0.007). While phlebitis , catheter related infection , catheter obstruction , the complications such as tube out between two groups, no statistically significant difference was found (P>0.05).Experimental group had lower patients ’ satisfaction and comfort scores than control group , and the difference was statistically significant [(1.02 ±0.27) vs (2.16 ±0.35),(1.32 ±0.61) vs (2.45 ±0.67), t =1.173,1.528,respectively; P <0.05]. Conclusions Using the puncture vascular direction fixing way can reduce the local bleeding of PICC application and maintenance process , at the same time can prevent the PICC catheter fracture and increase patients ’ satisfaction and comfort in clinic .It is worth promoting clinically .