摘要
目的探讨经外周穿刺植入中心静脉管后改良固定方法减少特殊皮肤病患者皮肤再损伤的临床效果。方法收集2012年1月至2019年2月住院因疾病治疗需要留置PICC同时伴有特殊皮肤损伤患者60例,采用历史对照回顾性方法分析不同固定方法出现皮肤再损伤的情况。常规固定方法为纱布加纱布绷带固定导管;改良固定,方法1为采用碘伏浸透无菌无纺布纱布覆盖皮肤创面,上覆盖干燥无菌纱布,再用纱布绷带交叉固定;改良固定方法2为改用干燥的无菌无纺布纱布覆盖在皮肤上,导管固定在纱布上再用裁剪后的透明贴膜,外加纱布绷带交叉缠绕固定。结果观察组皮肤再损伤率明显低于对照组,差异有统计学意义(P<0.05)。观察组皮肤痊愈率为81.81%明显高于对照组的62.96%,差异有统计学意义(P<0.05)。观察组的并发症导管外移、感染、堵管和血栓形成明显低于对照组,观察组的渗血渗液情况高于对照组,差异均有统计学意义(P<0.05)。结论改良导管固定方法取材方便,不增加患者费用,固定牢固,不易脱管,经临床观察效果很好,值得临床推广,也可用于PICC相关严重皮肤过敏患者。
Objective To investigate the clinical efficiency of peripherally inserted central catheters(PICC)modified fixation method in preventing the reinjury of skinin patients with special skin injury.Methods A total of 60 patients with special skin injury who had to receive PICC in our hospital from January 2012 to February 2019 were enrolled in the study.The historical control retrospective method was used to analyze the reinjury status of skin of patients after treated by different fixation methods.The conventional fixation method was that bandage+gauze bandage fixed catheter,however,the modified catheter fixation method 1 was that iodophor immersed aseptic non-woven gauze was used to cover skin wounds,then dry aseptic gauze was covered,and then gauze bandage was used to cross-fix,and the modified fixing method 2 was to cover the skin with dry sterile non-woven gauze to fix the catheter on the gauze,then using the transparent film after cutting,and fixing the gauze bandage by cross-winding.Results The skin reinjury rate in observation group was significantly lower than that in control group(P<0.05).The cure rate of skin in observation group was 81.81%,which was significantly higher than that(62.96%)in control group(P<0.05).Moreover the incidence rates of complications including catheter moving outside,infections,catheter blocking and thrombopoiesis in observation group were significantly lower than those in control group(P<0.05),but the incidence of errhysis in observation group was significantly higher than that in control group(P<0.05).Conclusion The modified catheter fixation method is convenient to obtain materials,which does not increase the cost of patients,which can fixe the catheter firmly,and the catheter is not easy to take off,with better clinical effects,therefor,it is worthy of clinical promotion.
作者
尹欣欣
朱玉欣
张欣
YIN Xinxin;ZHU Yuxin;ZHANG Xin(Department of Oncology, The First Hospital of Shijiazhuang City, Hebei, Shijiazhuang 050011,China)
出处
《河北医药》
CAS
2020年第9期1422-1425,1429,共5页
Hebei Medical Journal
基金
石家庄市科学技术研究与发展指导计划项目(编号:181460493)。
