摘要
目的探讨乳腺癌患者经外周置入中心静脉导管(peripherally inserted central catheter,PICC)术后置管侧上肢自我感觉症状以及症状群的分布特点,为PICC患者症状管理提供指导。方法选取PICC置管术后346例乳腺癌患者为研究对象,采用自制的上肢感觉症状调查表进行调查。结果PICC术后患者置管侧上肢存在多种症状,发生率最高的3个症状分别是穿刺点瘙痒(26.6%)、穿刺点疼痛(20.5%)、上肢僵硬(24.6%)。在3个月内、3~个月及5~7个月不同时间点患者穿刺点疼痛感发生率、穿刺点瘙痒感发生率、上肢麻木感发生率、上肢僵硬感发生率、肩关节活动障碍发生率比较,差异均有统计学意义(P<0.05,P<0.001),其中穿刺点疼痛在术后3个月内发生率最高,其分别与3~个月和5~7个月发生率比较,差异均有统计学意义(均P<0.017);穿刺点瘙痒感、上肢麻木感、上肢僵硬感、肩关节活动障碍在术后5~7个月内发生率最高,其分别与3个月和3~个月发生率比较,差异均有统计学意义(均P<0.017)。上肢沉重感、肿胀感术后不同时间段发生率比较,差异均无统计学意义(均P>0.05)。结论乳腺癌患者PICC置管术后存在多个症状,分布时段不同且以群集现象存在。护理人员在进行症状管理时应根据置管时间长短及症状群集特点而采取相应的干预和护理措施,从而减轻患者置管侧上肢不适感。
Objective To investigate the distribution of self-sensory symptoms and symptom groups in the upper limbs of patients with breast cancer after PICC catheterization so as to provide guidance for symptom management.Method A self-designed upper limb sensory symptom questionnaire was used to investigate the upper limb sensory symptoms and symptom groups among 346 patients with breast cancer after PICC catheterization.Results There were multiple symptoms in the upper limbs after PICC catheterization.The three symptoms with the highest incidences were pruritus at puncture point(26.6%),pain at puncture point(20.5%)and stiffness of upper limb(24.6%).The differences in the incidences of pains at the puncture point,and the numbness,stiffness and shoulder joint dysfunction in upper limbs were significant at the three time points:within 3 months,between 3~5 months and between 5~7 months(P<0.05,P<0.001).The pain at the puncture point had the highest incidence within 3 months after operation,with significant differences from the other two time points(P<0.017).The pruritus at puncture point,numbness,stiffness and shoulder joint dysfunction had the highest incidences at the time point of 5~7 months after operation,with the significant differences from the other two time points(P<0.017).The heaviness and swelling of upper limbs had the highest incidences(21.6%and19.0%),significantly different from the other two time points(P>0.05).Conclusions There are multiple symptoms in the patients with breast cancer after PICC catheterization,which come out across different periods after operation.Nurses should take targeted intervention and nursing measures based on the post-catheterization spans as well as different symptoms so as to reduce the discomfort of catheterized upper limb.
作者
陈玲
王黎
李新萍
张静
张明帅
Chen Ling;Wang Li;Li Xinping;Zhang Jing;Zhang Mingshuai(Department of Nursing,Xinjiang Medical University Tumor Hospital,Urumqi,830011,China)
出处
《现代临床护理》
2019年第12期31-35,共5页
Modern Clinical Nursing
基金
新疆维吾尔自治区自然科学基金面上项目,项目编号为2017D01C395,2016D01C350。
