PICC穿刺点非炎性渗液原因分析与护理.docVIP

PICC穿刺点非炎性渗液原因分析与护理 　　【摘要】 目的：探讨经外周中心静脉导管（PICC）置管术后穿刺点出现非炎性渗液的原因与护理措施。方法：对12例PICC置管术后穿刺点出现非炎性渗液患者的护理进行总结与分析。结果：12例患者经加压包扎、加强换药及改善营养状况后，有11例能终止渗液，有1例因血管内接近穿刺点处的导管破裂而拔管。结论：PICC置管术后出现非炎性渗液与置管过程中损伤淋巴管有主要关系，与患者的营养状况、导管破裂、纤维蛋白鞘形成等有次要关系。正确、及时的维护能有效终止渗液，减少非计划拔管情况的发生。 　　【关键词】 PICC置管； 渗液； 护理 　　Causes Analysis and Nursing of Non Inflammatory Exudates of PICC Puncture Point/HUANG Li-ru，CHEN Liu，XIONG Jun-yi.//Medical Innovation of China，2015，12（29）：093-096 　　【Abstract】 Objective：To investigate the reason and nursing measures about the non inflammation exudates in puncture point after PICC intubation operation through peripheral center.Method：The nursing care of 12 patients with non inflammation exudates after taking PICC intubation operation were summarized and analyzed.Result：12 patients after pressure dressing，strengthen the dressing change and improve the nutritional status，exudates of 11 cases were terminated，there was 1 case in which the catheter was pulled out because of the duct burst in blood vessel that was near to puncture point.Conclusion：The damage of lymph-vessel that happens in the process of intubation operation takes main effect on the appearance of non inflammation exudates after taking PICC intubation operation，nutrition status，duct burst and the form of fibrin sheath take minor effect.Correct and timely maintenance can effectively stop the exudates and reduce the happening of unplanned extubation. 　　【Key words】 Ultrasound-guided PICC； Exudates； Nursing 　　First-author’s address：Affiliated Cancer Hospital of Sun Yat-sen University，Guangzhou 510000，China 　　doi：10.3969/j.issn.1674-4985.2015.29.028 　　外周中心静脉置管（peripherally inserted central catheters，PICC）是指经外周静脉（贵要静脉、肘正中静脉、头静脉）穿刺插管，使其导管末端位于上腔静脉或锁骨下静脉，为患者提供中期至长期的静脉治疗通道。PICC具有安全、可靠、留置时间长、并发症少等优点，在临床上得到了广泛应用[1]。目前已被广泛运用于肿瘤患者、长期静脉高营养及危重症患者。近年来，本院已全面开展B超引导下改良塞丁格技术，为患者提高穿刺成功率及舒适性的同时，穿刺点非炎性渗液的情况也随之增多。现对12例出现非炎性渗液的患者进行原因分析并总结护理经验，现报告如下。 　　1 临床资料 　　2013年1月-2014年12月，本区共有521例诊断为鼻咽癌，分期为Ⅲ～Ⅳa期的患者，接受了在B超引导下改良塞丁格技术留置PIC