林鹤 林鹿 马淑英

[摘要] 目的 探讨引起经周围静脉穿刺置入中心静脉导管患者并发症的原因及相关护理对策。 方法 选择2007年5月～2010年5月笔者所在科室收治的行PICC置管患者385例，对其中发生并发症的26例患者的详细观察记录资料进行分析，找出发生并发症的原因，并给予相应的护理对策。 结果 发生并发症的26例PICC置管患者中，有静脉炎12例，导管阻塞3例，导管相关性感染2例，穿刺点渗血1例，血栓形成2例，导管断裂（体外）3例，导管脱出1例，穿刺点皮肤过敏2例。经相应护理后，有22例导管成功留置，4例拔除。 结论 经临床观察总结，PICC留置期间所引起的多数并发症都有规律可循，通过医护人员与患者的共同重视，可极大程度地降低其发生率及损害程度。

[关键词] 中心静脉置管；并发症；原因分析；护理对策

[中图分类号] R473.6???[文献标识码] B???[文章编号] 2095-0616（2012）15-134-03

Complications of reason analysis and care strategy of 385 cases of PICC patients

LIN?He1??LIN?Lu2??MA?Shuying1

1.Internal Medicine of Jilin Cancer Hospital,Changchun 130012,China;2.Large Two Treatment Area of Jilin Electric Power Hospital,Changchun 130022,China

[Abstract] Objective To investigate the reason and care strategy of PICC complications in 385 patients. Methods Selecting 385 patients who were treated in Jilin cancer hospital and used PICC from May 2007 to May 2010.To analyze the detail observation data of 26 patients who occurred complications,and to found out the reason. Results 12 cases were phlebitis,3 cases were catheter obstruction,2 cases were catheter-related infections, 1 case was puncture site bled,2 cases were thrombosis,3 cases were catheter fracture(in vitro),1 case was catheter prolapse and 2 cases were puncture point of skin allergies.After the appropriate care,22 cases were successful in catheter indwelling,4 cases were extubation. Conclusion By clinical observation summary,it have a pattern that the majority complications during PICC indwelling.Through the joint attention of the medical staff and patients,it can greatly reduce the incidence and extent of damage.

[Key words] PICC;Complication;Reason analysis;Care strategy

经周围静脉穿刺置入中心静脉导管（peripheral vein central catheter，PICC）为长期输液的肿瘤患者提供了一条有效的治疗途径，它具有很多优点，但也有一些并发症，在使用过程中密切观察，及时有效地发现和处理相应的并发症，认真加以保护，才能保证导管的正常使用，减轻患者的痛苦。通过对PICC置管患者并发症的原因分析，给予了相应的护理措施，规范了医护人员对PICC置管后日常护理的操作行为，减少了因并发症导致的拔管例数，加强了质量监控，提高了护理质量。现对笔者所在科室2007年5月～2010年5月行PICC置管的385例患者26例发生并发症的原因进行回顾性分析及相应护理对策，现报道如下。……