CAJ | 학술논문

目的：探讨胃癌患者使用PICC发生导管相关性并发症的原因及护理对策。方法：对2011年1月～2012年6月期间在我院腹外科进行PICC置管的86例胃癌患者的临床资料进行回顾性研究。对这86例患者均进行PICC置管，并对其进行护理干预。然后，观察这86例患者进行PICC置管的成功率、导管留置的时间、发生导管相关性并发症的原因，并采用有针对性的护理措施。结果、结论：这86例患者进行PICC 置管一次穿刺的成功率为95.3%。这些患者置管的时间为7～210天。导致这86例患者发生导管相关性并发症的原因为机械性静脉炎、导管堵塞、穿刺点渗血、导管异位、皮肤过敏和导管置入困难等，对出现并发症的患者进行护理干预的具体措施为：对机械性静脉炎患者使用局部湿敷及外涂软膏进行治疗，对导管堵塞患者使用肝素钠生理盐水或尿激酶进行冲管处理，对穿刺点出现渗血的患者进行局部按压处理，对导管出现异位的患者进行部分退管处理，对皮肤过敏患者进行相应的脱敏处理，对导管置入困难的患者选择合适的血管进行置管。
목적：탐토위암환자사용PICC발생도관상관성병발증적원인급호리대책。방법：대2011년1월～2012년6월기간재아원복외과진행PICC치관적86례위암환자적림상자료진행회고성연구。대저86례환자균진행PICC치관，병대기진행호리간예。연후，관찰저86례환자진행PICC치관적성공솔、도관류치적시간、발생도관상관성병발증적원인，병채용유침대성적호리조시。결과、결론：저86례환자진행PICC 치관일차천자적성공솔위95.3%。저사환자치관적시간위7～210천。도치저86례환자발생도관상관성병발증적원인위궤계성정맥염、도관도새、천자점삼혈、도관이위、피부과민화도관치입곤난등，대출현병발증적환자진행호리간예적구체조시위：대궤계성정맥염환자사용국부습부급외도연고진행치료，대도관도새환자사용간소납생리염수혹뇨격매진행충관처리，대천자점출현삼혈적환자진행국부안압처리，대도관출현이위적환자진행부분퇴관처리，대피부과민환자진행상응적탈민처리，대도관치입곤난적환자선택합괄적혈관진행치관。
Objective: Analysis of the causes of PICC related complications in gastric cancer patients, to explore the effective nursing measures. Methods: 86 cases of patients with gastric cancer were selected, observe the success rate of PICC, indwelling time of catheter, catheter related complications, etc., and give the effective nursing intervention. Result s: 6 patients appeared to have mechanical phlebitis, catheter obstruction in 5 cases, 5 cases of the puncture site bleeding, catheter heterotopia, skin allergies in all 4 cases, 3 cases of catheter placement difficulties. Complications can be effectively controlled after analyzing the causes and giving the corresponding nursing measures. Conclusion: Implementation of PICC access system, strictly implementation of aseptic, standardized operation, are the important guarantee of the successful implementation of PICC.