CAJ | 학술논문

目的将循证护理方法应用于PICC置管后护理,总结出有效的预防并发症的措施.方法采用方便抽样法选取2011年1月至2013年1月在湖南省肿瘤医院置入PICC的患者1490例,采用随机数字表法分为对照组(n =758)和观察组(n=732),对照组给予常规护理,观察组采用循证护理方案.针对PICC置管后常见的并发症(静脉炎、导管异位、穿刺点感染和穿刺点出血)查阅相关资料和文献,总结这些并发症的原因及解决方案的理论依据,并进行分析、归纳,结合临床实践,制订出相应的护理方案并在观察组患者中实施.结果观察组PICC置管术后静脉炎、导管异位、穿刺点感染、穿刺点出血的发生率均明显低于对照组(3.14％比8.97％,P=0.023; 4.23％比11.74％,P=0.021；3.96％比8.44％,P=0.001；4.92％比12.66％,P=0.011).结论在留置PICC导管的患者中应用循证护理可减少PICC置管后并发症的发生,提高临床护理质量.
목적 장순증호리방법응용우PICC치관후호리,총결출유효적예방병발증적조시.방법 채용방편추양법선취2011년1월지2013년1월재호남성종류의원치입PICC적환자1490례,채용수궤수자표법분위대조조(n =758)화관찰조(n=732),대조조급여상규호리,관찰조채용순증호리방안.침대PICC치관후상견적병발증(정맥염、도관이위、천자점감염화천자점출혈)사열상관자료화문헌,총결저사병발증적원인급해결방안적이론의거,병진행분석、귀납,결합림상실천,제정출상응적호리방안병재관찰조환자중실시.결과 관찰조PICC치관술후정맥염、도관이위、천자점감염、천자점출혈적발생솔균명현저우대조조(3.14％비8.97％,P=0.023; 4.23％비11.74％,P=0.021；3.96％비8.44％,P=0.001；4.92％비12.66％,P=0.011).결론 재류치PICC도관적환자중응용순증호리가감소PICC치관후병발증적발생,제고림상호리질량.
Objective To sum up effective measures to prevent complications of peripherally inserted central catheter (PICC) by applying evidence-based nursing in patients after PICC insertion.Methods From January 2011 to January 2013,1490 patients inserted with PICC in Hunan Provincial Tumor Hospital were selected by convenience sampling,whom were divided into control group (n =758) and observation group (n =732) with random number table.The control group received routine care,while the observation group received evidence-based nursing.Nursing program for the observation group was formed based on literature regarding the causes of and solutions for phlebitis,malposition of PICC,infection of insertion sites,and hemorrhage of insertion sites.Results The incidences of postoperative phlebitis,malposition of PICC,infection of insertion sites,and hemorrhage at insertion sites in the observation group were significantly lower than those in the control group (3.14％ vs.8.97％,P=0.023;4.23％ vs.11.74％,P=0.021;3.96％ vs.8.44％,P=0.001;4.92％vs.12.66％,P =0.011).Conclusions The application of evidence-based nursing in patients with PICC insertion could effectively reduce the complication,and improve the quality of clinical nursing care.