CAJ | 학술논문

目的：比较3种固定方法在腰大池置管持续引流患者中的应用效果。方法将120例行腰大池置管持续引流术的患者按随机数字表法分为3组，每组各40例，分别采取肩部固定法、腰部固定法和腰部改良固定法，比较3组患者置管后留置期间并发症的发生、固定部位皮肤损伤情况及患者满意度。结果采取肩部固定法、腰部固定法和腰部改良固定法的3组患者发生管路滑脱分别为5，4，0例，发生引流不.分别为7，6，1例，发生穿刺点感染分别为8，8，2例，发生脑脊液漏分别为5，6，0例，发生颅内感染分别为7，9，1例，3组比较差异有统计学意义（χ2值分别为5．05，5．01，4．71，6．21，7．13；P＜0.05）。3组患者换药次数分别为（10±1．78），（10±2．28），（3±1．13）次，差异有统计学意义（F ＝23.54，P＜0．05）。3组患者压疮发生例数分别为7，5，0例，满意例数分别为20，24，33例，3组比较差异有统计学意义（χ2值分别为7．20，9．64，P＜0．05）。结论腰部改良固定法的运用减少了腰大池置管持续引流的并发症，减少了固定部位皮肤损伤情况、提高了患者的满意度，增加了管路固定的有效性，具有临床应用意义。
목적：비교3충고정방법재요대지치관지속인류환자중적응용효과。방법장120례행요대지치관지속인류술적환자안수궤수자표법분위3조，매조각40례，분별채취견부고정법、요부고정법화요부개량고정법，비교3조환자치관후류치기간병발증적발생、고정부위피부손상정황급환자만의도。결과채취견부고정법、요부고정법화요부개량고정법적3조환자발생관로활탈분별위5，4，0례，발생인류불.분별위7，6，1례，발생천자점감염분별위8，8，2례，발생뇌척액루분별위5，6，0례，발생로내감염분별위7，9，1례，3조비교차이유통계학의의（χ2치분별위5．05，5．01，4．71，6．21，7．13；P＜0.05）。3조환자환약차수분별위（10±1．78），（10±2．28），（3±1．13）차，차이유통계학의의（F ＝23.54，P＜0．05）。3조환자압창발생례수분별위7，5，0례，만의례수분별위20，24，33례，3조비교차이유통계학의의（χ2치분별위7．20，9．64，P＜0．05）。결론요부개량고정법적운용감소료요대지치관지속인류적병발증，감소료고정부위피부손상정황、제고료환자적만의도，증가료관로고정적유효성，구유림상응용의의。
Objective To compare the effect of three fixed methods in patients with lumbar catheters continuous drainage.Methods One hundred and twenty patients with lumbar catheters continuous drainage were chosen and divided into three groups according to the random number table, each with 40 cases.Three groups received the shoulder fixation, lumbar fixation and modified lumbar fixation, respectively.The incidence of complication after catheter, the skin injury in the fixed position and the patients’ satisfaction were compared in three groups.Results The cases of patients with pipe slip were respectively 5,4,0 in three groups, and the cases of patients with poor drainage were respectively 7,6,1, and the cases of patients with puncture point infection were respectively 8,8,2, and the cases of patients with cerebrospinal fluid leak were respectively 5,6, 0, the cases of patients with intracranial infection were respectively 7,9,1, and the differences were statistically significant in three groups (χ2 =5.05,5.01,4.71,6.21,7.13, respectively;P <0.05).The number of changing dressings were respectively (10 ±1.78),(10 ±2.28),(3 ±1.13) in three groups, and the difference was statistically significant (F=23.54,P<0.05).The cases of patients with pressure ulcers were respectively 7,5, 0 in three groups, and the cases of patients with satisfaction were respectively 20, 24, 33, and the differences were statistically significant in three groups (χ2 =7.20,9.64, respectively;P <0.05). Conclusions Application of the modified lumbar fixation can reduce the incidence of complication of lumbar catheters continuous drainage, and reduce the skin injury, and increase the patients’ satisfaction, and is worthy of clinical promotion.