乳腺癌患者患侧置入PICC管的方法及护理.docVIP

乳腺癌患者患侧置入PICC管的方法及护理 何江冯鹤媛侯玉清易全芳 ［摘要］目的探讨乳腺癌患者在患乳腺癌5年后患侧上肢置入PICC管的临 床效果。方法对经B超检查血管无畸形、通畅，患侧上肢无肿胀的20例患者实 施患侧上肢PICC置管，在置管前、置管中、置管后均给予全程系统化整体护理 及维护，密切观察并发症并正确及时处理。结果20例患者均经贵要静脉顺利置 管，其中5例经肘上，15例经肘下置入。经胸片显示：导管尖端均进入上腔静 脉中下段。其中1例出现机械性静脉炎;1例出现穿刺点渗液，经积极处理症状改 善。导管留置时间116?138d,顺利完成6个疗程化疗。结论正确评价患者患 侧上肢血管，置管过程中严格执行无菌技术及操作规程、护患配合协作，术后及 时发现并正确处理并发症。乳腺癌患者患侧上肢不再是PICC的禁忌证，可进行 PICC置管，为双侧乳腺癌患者提供了安全、可靠、方便的静脉输液通道。 ［关健词】乳腺癌 患侧 化疗 PICC DOI:10.3760/cma.j.issn.1672-7088.2014.21.13 作者单位：637000,四川南充，川北医学院附属医院普外三科 ［作者简介］何江（1971-）,女，汉，木科，副主任护师，护士长。 木文系川北医学院附属医院院内课题（川北医附字院［2013］110号）。 The Method of PICC Catheter in the Upper Diseased Side among Breast Cancer Patients and Its Nursing He Jiang, Feng Heyuan, Hou Yuqing, Yi Quanfang Abstract: Objective To study the clinical effect of PICC in the upper diseased side of breast cancer patients after five years diagnosed. Methods Twenty patients with no vascular malformation, no obstruction and no swelling of the upper diseased side detected by B ultrasonic examination were conducted with PICC catheter. Systematic holistic nursing and maintenance were applied at all the process and the complications were closely observed and properly handled in time. Results All patients catheterized successfully by basilica vein, 5 cases through upper elbow, the other 15 cases through lower elbow. The X-ray showed that all catheter tips were in the lower end of superior venous cavity. Among them 1 case appeared mechanical phlebitis, 1 cases with the puncture point solutions, all the complications were improved with positive treatment. The indwelling time was 116-138 days, and six cycles of chemotherapy completed. Conclusion Correct evaluation of upper extremity vascular, strict aseptic technique in the process of catheter, cooperation between nurses and patients, postoperative complications timely discovered and corrected made the upper diseased side of breast cancer patients is no longer a taboo of PICC. PICC could provide a safety, reliable and convenient transfusion