摘要
目的:调查ICU患者外周动脉导管并发症发生情况,并分析穿刺部位渗血的影响因素。方法:选取2021年1月至2022年7月入住某三级甲等医院ICU的患者,采用自行设计的资料收集表记录患者的基本资料、动脉导管置管情况、并发症发生情况及动脉导管相关感染情况,并采用Logistic回归分析穿刺部位渗血的影响因素。结果:共纳入1130名患者的1197例次动脉导管置管。其中,93.8%的置管部位为桡动脉,5.3%为肱动脉,82.6%的置管场所为手术室,40.4%的导管留置时间为48 h以上。有67例次(5.6%)导管因各种并发症在非计划时间内拔除。常见并发症依次为穿刺部位渗血(15.3%)、波形不准确(9.9%)、主诉疼痛(6.5%)、导管打折(6.2%)等。对留置48 h以上的329例导管留取尖端标本和皮肤拭子微生物送检,导管定植率为2.4%。对并发症发生率最高的穿刺部位渗血进行的多因素分析结果显示,导管留置时间、置管场所是其影响因素。结论:ICU患者留置动脉导管期间常见并发症发生率较高。应加强局部并发症观察,减少导管功能不良的发生,关注患者导管定植情况和留置期间的主观感受,早期采取针对性的预防措施。
Objective:To investigate the incidence of complications during peripheral arterial catheterization and analyze the influencing factors of puncture-site bleeding in ICU patients.Methods:Patients admitted to ICU in a tertiary grade A hospital in Beijing from January 2021 to July 2022 were selected as the research objects.A self-designed data collection table was used to record patients'basic information,catheterization,complications and infections.The influencing factors of puncture-site bleeding was analyzed by using Logistic regression.Results:A total of 1197 arterial catheters were observed in 1130 patients,93.8%were radial artery catheterization,5.3%were brachial artery catheterization,82.6%were indwelt in operating room,and 40.4%indwelling time was more than 48 hours,5.6%were removed unplanned due to complications.The common complications were puncture-site bleeding(15.3%),inaccurate waveform(9.9%),pain complaint(6.5%),catheter disrepair(6.2%),etc.The catheter specimens and skin swabs of 329 patients with indwelling for more than 48 hours were routinely collected for microbial examination.The infection rate of colonization was 2.4%.Multivariate analysis showed that the catheter indwelling time and catheterization site were the influencing factors of puncture-site bleeding.Conclusion:The incidence of common complications in ICU patients during indwelling arterial catheter is still high.It is necessary to strengthen the observation of local complications,reduce the poor function of catheter,pay attention to the patient's colonizing bacteria infection and subjective feelings during indwelling,and take targeted preventive measures early.
作者
袁翠
杨晓旸
肖艳艳
王轶
王芳
杨祎
崔佳
郭立娜
刘立亚
胡美华
李双玲
蒙景雯
YUAN Cui;YANG Xiaoyang;XIAO Yanyan;WANG Yi;WANG Fang;YANG Yi;CUI Jia;GUO Lina;LIU Liya;HU Meihua;LI Shuangling;MENG Jingwen(Intensive Care Unit,Peking University First Hospital,Beijing,100034,China)
出处
《中国护理管理》
CSCD
2022年第11期1612-1617,共6页
Chinese Nursing Management
基金
北京大学第一医院科研种子基金(2019SF83)。
关键词
重症监护病房
外周动脉导管
并发症
影响因素
动脉血标本
Intensive Care Unit
peripheral arterial catheter
complication
influencing factor
collection of arterial blood
