李君丽+黄芳艳+刘佳+陆菁+杨梅

【摘要】目的探讨微波理疗与加味双柏散联合干预在预防经外周静脉穿刺置入中心静脉导管（PICC）机械性静脉炎中的应用效果。方法将2013年12月～2015年12月留置PICC的93例患者，随机分为观察组（48例）和对照组（45例）。对照组置管后予常规维护，观察组置管后在常规维护基础上给予微波理疗与加味双柏散联合干预，比较两组患者PICC机械性静脉炎的发生率。结果观察组发生机械性静脉炎3例，发生率为6.25%，对照组发生机械性静脉炎12例，发生率为26.67%，两组比较，差异有统计学意义（χ2=7.157，P<0.01）。结论微波理疗与加味双柏散联合干预可降低肿瘤患者留置PICC机械性静脉炎的发生率，延长导管使用时间，降低患者痛苦，减少医疗费用，提高PICC安全性，值得临床上推广应用。

【关键词】PICC；机械性静脉炎；微波理疗；加味双柏散

中图分类号：R543.6文獻标识码：ADOI：10.3969/j.issn.10031383.2016.05.013

【Abstract】ObjectiveTo investigate the application effect of combined intervention of microwave physiotherapy and modified Shuangbai powder in preventing peripheral inserted center catheter（PICC）mechanical phlebitis.Methods93 patients with indwelling PICC from December，2013 to December，2015 were randomly divided into observation group（48 cases） and control group（45 cases）.The control group were given regular maintenance after indwelling catheter，and based on which the observation group were given combined intervention of microwave physiotherapy and modified Shuangbai powder.Then，incidence of PICC mechanical phlebitis of the two groups was compared.Results Mechanical phlebitis was found in 3 cases in the observation group，incidence rate was 6.25%，and it was found in 12 cases in the control group，incidence rate was 2667%，so difference was statistically significant（χ2=7.157，P<0.01）.ConclusionCombined intervention of microwave physiotherapy and modified Shuangbai powder can reduce the incidence rate of PICC mechanical phlebitis in cancer patients，prolong use time of the catheter，alleviate patients pain，reduce medical expenses，improve the safety of PICC.Thus，it is worthy of clinical popularization and application.

【Key words】PICC；mechanical phlebitis；microwave physiotherapy；modified Shuangbai powder

经外周静脉穿刺置入中心静脉导管（peripheral inserted center catheter，PICC）是经上肢的肘部静脉或下肢的隐静脉（新生儿）等外周静脉穿刺置管，导管尖端位于上、下腔中心静脉的导管，因其留置时间长（可留置1年），可避免反复静脉穿刺，减轻患者痛苦，在临床上广泛应用于肿瘤化疗、静脉营养治疗及长期静脉输液等患者[1]，是一条安全、快捷、效果良好的静脉治疗途径。随着PICC的广泛应用，其并发症也日益凸显，机械性静脉炎（mechanial phlebitis，MP）是PICC置管术后的常见并发症之一，张娜等人[2]研究报道常规护理下MP发生率高达20%，国外报道为15.15%[3]。前瞻性预防MP的发生是护理工作必须解决的重要问题。我院肿瘤科2013年12月～2015年12月采用微波理疗与加味双柏散联合干预，预防PICC置管后MP的发生，效果良好。

1资料与方法1.1临床资料选取2013年12月～2015年12月在我科住院，病理确诊为恶性肿瘤需要留置PICC进行化疗的患者93例，主要是乳腺癌、鼻咽癌、肺癌、胃癌、宫颈癌、淋巴瘤等肿瘤化疗患者；……