CAJ | 학술논문

目的：实施 PICC 置管前全面评估，确保置管安全，减少并发症。方法基于近年来 PICC 置管前评估大量循证研究，设计置管前评估流程图，该流程图分为3个阶段，按照“患者是否适合使用 PICC、哪侧上肢适合留置 PICC、上肢的哪条静脉适合穿刺 PICC 以及穿刺时的注意事项”的顺序分6个步骤，在临床应用于82例患者的 PICC 置管前评估。结果经评估，82例患者中不适合置入 PICC 的患者有10例；在适合置入 PICC 的72例患者中，双侧上肢风险评估未见异常者有55例，均选择非主利手上肢置入 PICC；高风险者17例，选择健侧上肢置入 PICC 14例，选择患侧上肢置入 PICC 2例，改选输液港置入1例。穿刺中、置管后未出现因评估不全导致的相关并发症。结论 PICC 置管前评估流程图可以指引 PICC 护士实施全面、正确评估，具有内容全面、条理清晰、逻辑性强、及时给出指导、缩短评估时间等优点，有利于客观评价 PICC 适应证、禁忌证及风险因素，便于确认 PICC穿刺侧肢体及静脉。
목적：실시 PICC 치관전전면평고，학보치관안전，감소병발증。방법기우근년래 PICC 치관전평고대량순증연구，설계치관전평고류정도，해류정도분위3개계단，안조“환자시부괄합사용 PICC、나측상지괄합류치 PICC、상지적나조정맥괄합천자 PICC 이급천자시적주의사항”적순서분6개보취，재림상응용우82례환자적 PICC 치관전평고。결과경평고，82례환자중불괄합치입 PICC 적환자유10례；재괄합치입 PICC 적72례환자중，쌍측상지풍험평고미견이상자유55례，균선택비주리수상지치입 PICC；고풍험자17례，선택건측상지치입 PICC 14례，선택환측상지치입 PICC 2례，개선수액항치입1례。천자중、치관후미출현인평고불전도치적상관병발증。결론 PICC 치관전평고류정도가이지인 PICC 호사실시전면、정학평고，구유내용전면、조리청석、라집성강、급시급출지도、축단평고시간등우점，유리우객관평개 PICC 괄응증、금기증급풍험인소，편우학인 PICC천자측지체급정맥。
Objective To conduct comprehensive assessment before PICC catheterization for the safety of catheterization and reducing complications. Methods An assessment flowchart for PICC catheterization including three phases and six steps was developed based on recent evidence -based researches on assessment before PICC catheterization, then it was applied in the assessment of 82 patients clinically. Results After assessment, PICC was placed based on patients’ individual condition and no complications were found induced by incomplete assessment in and after the catheterization. Conclusion Assessment flowchart for PICC catheterization benefits nurses’ overall evaluation of patients’ condition and the indication, contraindication and risk factors of PICC.