肿瘤化疗患者股静脉置管及护理.docVIP

肿瘤化疗患者股静脉置管及护理 　　摘要：外周血管应用化疗已经不适应肿瘤患者反复住院、多次化疗以及晚期患者对静脉营养支持的需要。外周血管位置表浅、管径细小、血流速度缓慢，化疗药物反复多次经外周给药及化疗药物长时间停留局部刺激血管壁，使得管壁变硬、弹性差，血管及周围组织出现炎性疼痛甚至坏死。血管颜色发黑呈条索状阴影。血管周围皮肤颜色变深，这种损伤恢复慢，容易影响和延误治疗。因此，近几年来，深静脉置管广泛应用于肿瘤化疗给药。常用的深静脉有锁骨下静脉、颈内外静脉、PICC经上腔静脉给药和股静脉置管从下腔静脉给药。股静脉管腔大，血流快，可以迅速将化疗药物带入血液循环，对血管损伤小。 　　关键词：肿瘤；化疗；股静脉置管；护理；健康教育 　　Nursing of Patients with Tumor Chemotherapy 　　CHEN Ting 　　（Gaochun Peoples Hospital of Nanjing City，Nanjing 211300，Jiangsu，China） 　　Abstract：Peripheral arterial chemotherapy has not adapted to the tumor patientshospitalized for many times repeatedly，chemotherapy and parenteral nutrition support in patients with advanced to the needs of.Peripheral vascular superficial location，small diameter，blood flow speed is slow，the chemotherapy drug repeatedly after peripheral administration of chemotherapeutic drugs and long time stay local stimulation of vascular wall，which makes the tube wall hardens，poor elasticity，blood vessels and surrounding tissue with inflammatory pain and even necrosis.Vascular color black like trabs shadow.Around blood vessels in the skin become darker in color，this kind of injury to restoreslower，easy to influence and delay treatment，increase the suffering of patients.Therefore，in recent years，deep vein pipe widely used in cancer chemotherapy drug.Commonly used deep vein subclavian vein，internal and external carotid vein，PICC through the superior vena cava to medicine and femoral vein puncture from inferior vena cava tomedicine.Femoral vein lumen，blood flow faster，you can quickly turn chemotherapy drugsinto the blood，small injury to blood vessels. 　　Key words：Tumor；Chemotherapy；Femoral vein catheter；Nursing；Health education 　　1 置管方法 　　1.1用物准备 深静脉穿刺包1个、ARROW中心静脉导管包1个、1%利多卡因5ml、肝素稀释液（浓度为25u/ml）、无菌手套2付、5%碘伏、75%酒精、棉签、3m透明敷贴、肝素帽、5ml注射器2付。 　　1.2方法 　　1.2.1患者取平卧位，其穿刺侧下肢轻微外展外旋，在腹股沟韧带中点的内下方1.5～3.0cm（即股动脉搏动之内侧）处定为穿刺点并标记。 　　1.2.2消毒 先用75%的酒精行顺时针，逆时针，顺时针三遍消毒，再行5%的碘伏行顺时针，逆时针，顺时针三遍消毒，后铺巾。 　　1.2.3用1%的利多卡因局部浸润麻醉腹股沟下股动脉搏动内侧皮肤及深部组织。 　　1.2.4