摘要
目的总结应用甲氨蝶呤后发生经外周静脉置入中心静脉导管（PICC）穿刺部位严重皮肤问题患儿的护理体会，为今后相似病例提供护理经验。方法北京大学人民医院血液病房为1例应用甲氨蝶呤后发生PICC穿刺部位严重皮肤问题患儿进行紫外线局部照射治疗后，选用碘伏及0.9%氯化钠注射液消毒局部皮肤，藻酸盐敷料覆盖破损处皮肤，无菌纱布固定PICC。结果经过22 d的护理，患儿PICC周围破损处疼痛及瘙痒消失，无渗出液，皮肤恢复正常。导管无脱出。结论儿童用药后PICC周围皮肤过敏由于局部症状及自身感受，使患儿易出现烦躁情绪。同时，由于治疗、护理时间较长，且由于不适易引起患儿哭闹，还会增加家长的心理负担。护理人员向患儿及家属讲解过敏发生的相关因素，并及时给予正确的护理干预，能够使过敏患儿局部症状好转，成功保留导管。
Objevtive To summarize the nursing experience of a child with serious skin problems at the puncturing site of peripherally inserted central catheter （PICC） for methotrexate （MTX） infusion.MethodsA pediatric patient from the Hematology Ward of Beijing University People＇s Hospital was found to be with serious skin problems at the puncturing site of PICC for MTX infusion. Local irradiation with ultraviolet, disinfection of local skin with iodine volts and 0.9% sodium chloride injection, coverage of the broken skin with alginate dressing, and fixation of PICC with sterile gauzes were applied.ResultsAfter 22 days of nursing, the pain and itching at the broken skin around PICC disappeared. The skin returned normal, without exudates and prolapse of catheter.ConclusionsAfter MTX use via PICC, the children can easily become irritable due to local symptoms and their own feelings after skin allergy. Meanwhile, prolonged treatment and nursing may make the child cry and increase the stress of parents. Caregivers needs to explain the related factors of allergy to the children and their families, and give the correct nursing intervention, so as to improve local allergy and facilitate the retention of PICC.
出处
《中华临床营养杂志》
CAS
CSCD
2017年第4期252-255,共4页
Chinese Journal of Clinical Nutrition
