乳腺癌化疗过程中锁骨静脉穿刺置管应用与护理方法及PICC的循证护理方法研究.docx

乳腺癌化疗过程中锁骨静脉穿刺置管应用与PICC在置管后的循证护理方法研究【摘要】目的 研究锁骨静脉穿刺置管在乳腺癌化疗过程中的应用方法与探讨PICC在乳腺癌化疗锁骨静脉穿刺置管后的循证护理体会。方法 选取哈尔滨医科大学第一医院2015年上半年60例乳腺癌患者，选择多西紫杉醇和表阿霉素为其进行锁骨下静脉穿刺置管化疗，并运用循证护理方法对其进行PICC置管后的护理。结果 患者中出现2例穿刺部位感染，3例导管脱落，在经过循证护理后所有患者均如期完成乳腺癌化疗。患者在置管化疗过冲中，未出现深静脉血栓、化学性和机械性静脉炎、局部组织坏死现象，同时也未发生化疗药物外漏、导管堵塞问题。结论 锁骨静脉穿刺置管化疗是乳腺癌化疗的主要方法之一，主要是将多西紫杉醇和表阿霉素通过患者锁骨下静脉穿刺置管的方法进行化疗，由于化疗药物本身具有较强的刺激作用，容易损伤患者血管，造成患者机械性静脉炎，并且其化学特性会影响细胞蛋白质和DNA的合成，如果药物外漏会引发患者血管内上皮细胞组织坏死。所以，在乳腺癌化疗过程中，采用锁骨静脉穿刺置管法进行化疗，并应用PICC在置管后进行循证护理，提高乳腺癌化疗质量，通过实践证明该方法具有非常好的实用性。【关键字】乳腺癌化疗；PICC置管；循证护理【中图分类号】R734.2 【文献标识码】A 【文章编号】Study on the application of PICC in the treatment of breast cancer chemotherapy and the evidence based nursing method after intubation[Abstract] Objective To study the application of in the course of chemotherapy for breast cancer, and to explore the evidence based nursing experience of PICC in breast cancer chemotherapy. Methods from 2015 the first hospital of Harbin Medical University, the first half of the 60 cases of breast cancer patients, selected with docetaxel and epirubicin for the subclavian vein catheterization chemotherapy, and the use of evidence-based nursing care after PICC catheter on it. Results in the patients, 2 cases were infected, and 3 cases were treated with catheter. All patients were treated with the evidence based nursing. The patients in the treatment of chemotherapy, there is no deep venous thrombosis, chemical and mechanical phlebitis, local tissue necrosis phenomenon, but also did not occur chemotherapy drug leakage, catheter blockage problem. Conclusion subclavian vein catheterization chemotherapy is one of the main methods of chemotherapy for breast cancer, mainly to chemotherapy with docetaxel and epirubicin in patients with subclavian vein tube method, because chemotherapy drugs itself has a strong stimulating effect, easy to damage the patient blood vessels, causing takepiccobserve, synthesis and its chemical characteristics effect of cell protein and DNA, if the drug leakage