王松敏+武昆利+张敏+薛莲

摘要：目的 探讨经外周静脉穿刺植入中长度导管在结核性脑膜炎患者输液中的应用与护理。方法 总结20例患者置管过程中的护理经验，针对发生的情况采取相应的护理措施。结果 20例中长度导管留置患者穿刺一次成功，导管外移占80.00%，渗血渗液占75.00%。20例中长度导管平均留置9.6 d，其中左上肢9例，平均留置9.2 d；右上肢11例，平均留置10 d。结论 根据医生医嘱、治疗周期、患者个体特点等因素主动选择合适的输液装置，防止因药物刺激等造成静脉内膜出现严重组织学改变，进而造成外周血管损伤，同时把输液的危险因素，即选用错误装置给药，控制在输液治疗活动前，降低输液的风险，为进一步深入研究安全注射提供了新思路。

关键词：静脉输液；中长度导管；结核性脑膜炎

Application and Nursing of Medium-length Catheters in Patients with Tuberculous Meningitis

WANG Song-min，WU Kun-li，ZHANG Min，XUE Lian

（Department of Infectious Diseases of the Second，Third People's Hospital of Kunming，Kunming 650041，Yunnan，China）

Abstract：Objective To explore the application and nursing of peripherally inserted length of catheter in patients with tuberculous meningitis infusion. Methods The nursing experience of 20 cases of patients with indwelling catheter in the process of summing up，take corresponding nursing measures for the situation.Results In 20 cases the length of indwelling catheter in patients with a successful puncture，catheter migration 80.00%，oozing exudate accounted for in 75.00%.20 cases，9.6 d average length of indwelling catheter，9 cases of left upper limb， the average retention of 9.2 d；the right upper limb in 11 cases，the average indwelling 10 d.Conclusion According to the doctor's advice，treatment period，patients with factors such as the individual characteristics of active choice infusion device is appropriate，to prevent serious pathological changes of venous intima tissue due to drug stimulation， causing peripheral vascular injury，while the transfusion risk factors，namely the wrong device for medicine，infusion therapy in control before the event， reduce the risk of transfusion，provides a new idea for further research on safe injection.

Key words：Intravenous infusion；Medium length catheters；Tuberculous meningitis

静脉治疗是临床抢救和治疗的重要手段，据统计，目前在临床中住院患者的输液率为98%；门诊患者的输液率为14%。常用的静脉输液工具包括头皮鋼针、留置针、PICC、CVC以及PORT等输液装置多种形式并存。护士应在治疗方案、持续时间、能力和可获得的设备护理资源的基础上选择导管的类型，以满足患者血管通路所需。国内对中等长度导管的使用及研究报道尚少，有关调查静脉输液工具选择的文献中亦没有报道中等长度导管使用率的情况[1-2]。检索中文数据库，中等长度导管又被称为“中长导管”，笔者根据英文名“Midline catheter”将其直译为“中等长度导管”[3]。我科于2016年 4月～6月将中长度导管应……