不同程度血小板减少患者中心静脉置管临床护理研究.docVIP

不同程度血小板减少患者中心静脉置管的临床护理研究 　　[摘要] 目的 通过分析和研究血小板减少患者行中心静脉置管术中、术后出血并发症与血小板计数、凝血功能及基础疾病的关系，进一步指导临床治疗及护理工作。 方法 收集2013年1月～2015年9月北京朝阳医院京西院区存在血小板及凝血功能障碍并成功行中心静脉置管治疗的78例病例资料，根据血小板计数将其分为血小板明显减少组（血小板计数0～20×109/L）、血小板减少组（血小板计数20×109～50×109/L）、血小板轻度减少组（血小板计数50×109～100×109/L）；根据凝血功能将其分为凝血功能正常组、凝血功能明显异常组及凝血功能轻度异常组；根据基础疾病将其分为血液系统疾病组、脓毒血症性休克组及其他组。分析患者血小板计数、凝血功能及基础疾病与出现出血、血肿等并发症的关系，总结护理经验。 结果 血小板明显减少组及血小板减少组术后渗血及血肿等并发症明显多于血小板轻度减少组，差异有统计学意义（P 0.05）。凝血功能明显异常组术后发生渗血及血肿等并发症明显多于凝血功能正常组，差异有统计学意义（P 0.05）。 结论 血小板计数在50×109/L以上以及凝血功能轻度异常的患者，行中心静脉穿刺置管相对安全。 　　[关键词] 血小板减少；中心静脉置管；护理；凝血功能；并发症 　　[中图分类号] R473.72 [文献标识码] A [文章编号] 1673-7210（2016）05（b）-0138-04 　　[Abstract] Objective To analyze and study the relationship of intraoperative and postoperative bleeding complications of central venous catheter in patients with thrombocytopenia with the platelet count， coagulation function， basic disease， so as to provide guidance for the clinical treatment and nursing work. Methods The clinical data of 78 cases of patients with different degrees of thrombocytopenia after central venous indwelling catheter in Jingxi Branch of Beijing Chao-Yang Hospital from January 2013 to September 2015 were selected. According to the platelet count， the patients were divided into three groups， including platelet count decreased significantly group （platelet level was 0-20×109/L）， platelet count decreased group （platelet level was 20×109-50×109/L） and platelet count decreased mildly group （platelet level was 50×109-100×109/L）. According to the coagulation function， the patients were divided into three groups， including normal coagulation function group， significantly abnormal coagulation function group and mildly abnormal coagulation function group. According to the basic diseases， the patients were divided into three groups， including blood system diseases group， septic shock group and other group. The relationship of patients platelet count， coagulation function and basic diseases with the complications such as bleed