摘要
目的 探讨藻酸盐敷料和明胶海绵敷料对老年患者外周静脉穿刺中心静脉置管(PICC)后渗血和感染的护理效果.方法 选取杭州师范大学附属医院2020年7月-2022年5月收治的214例PICC置管的老年患者,随机分为研究组和对照组,各107例;对照组PICC置管后采用明胶海绵护理,研究组采用藻酸盐护理,比较两组置管后不同时间渗血和感染情况;并归纳老年患者外周静脉穿刺PICC渗血的危险因素.结果 两组患者在24、48、72、96 h内各时间段渗血的发生率差异无统计学意义;研究组患者渗血的程度较对照组轻(P<0.05);对照组首次换药时间早于研究组(P<0.05),96 h内换药频率高于研究组(P<0.05);年龄、凝血异常、合并糖尿病是老年患者PICC置管后渗血的危险因素(P<0.05);PICC置管后渗血患者发生感染7例,发生率30.43%,均为对照组,病原菌以表皮葡萄球菌为主.结论 PICC置管的老年患者采用明胶海绵和藻酸盐止血均有助于防治穿刺点渗血和感染,藻酸盐敷料更易减轻渗血程度和降低换药频率,降低感染风险;年龄、凝血异常、合并糖尿病是置管后穿刺点渗血的危险因素.
OBJECTIVE To investigate the impact of alginate treatment and gelatin sponge dressing on blood ooze and infection in elderly patients with peripherally inserted central catheter(PICC)via peripheral vein puncture.METHODS A total of 214 elderly patients with PICC in the Affiliated Hospital of Hangzhou Normal University from Jul.2020 to May 2022 were randomly selected and divided into a study group and a control group,with 107 cases in each group.The patients in the control group were treated with gelatin sponge after PICC catheterization,while the patients in the study group were treated with alginic acid,the blood leakage and infection at different times after placement in the two groups were compared,and the risk factors for peripheral venipuncture PICC leakage in the elderly patients were summarized.RESULTS There was no significant difference in the incidence of blood ooze at 24,48,72 and 96 h between the two groups.The degree of blood ooze in the study group was less severe than that in the control group(P<0.05).The first dressing change time in the control group was earlier than that in the study group(P<0.05),and the frequency of dressing change within 96 hours was higher than that in the study group(P<o.05).Univariate analysis showed that age,coagulation function and diabetes mellitus were related to blood ooze after PICC catheterization(P<0.05).Age,abnormal coagulation and combined diabetes mellitus were risk factors for blood oozing after PICC catheterization in elderly patients (P<0.05). Seven patientswith bleeding after PICC intubation developed infections, the incidence was 30.43%, all patients were in thecontrol group, with Staphylococcus epidermidis as the predominant pathogen. CONCLUSION The use of gelatinsponges and alginate for hemostasis in elderly patients with PICC intubation was helpful to prevent and control thebleeding and infection at the puncture site. The alginate dressing was more likely to alleviate the severity of bleeding,reduce the frequency of dressing change and the risk of infectio
作者
郑焠燕
LIU Zhi-mei;ZHENG Cui-yan(Affiliated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang 310015,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第19期3033-3036,共4页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技计划基金资助项目(2020KY719)。
关键词
经外周静脉穿刺中心静脉置管
藻酸盐敷料
明胶海绵敷料
渗血
感染
危险因素
Peripheral venipuncture central venous catheterization
Alginate dressing
Gelatin sponge dressing
Oozeblood
Infection
Risk factor
