蒋常英 黄新武 王凤娟

[摘要]目的 探讨胶带+棉线固定中心静脉导管方法在ICU患者中的应用效果。方法 选取2014年7月～2015年12月我院ICU病房留置中心静脉管道的120例患者作为对照组，选取2016年1月～2017年6月我院ICU病房留置中心静脉管道的120例患者作为实验组。对照组给予“人”型固定导管连接座并交叉固定输液连接座的中心静脉管道固定方法，实验组采用胶带+棉线的中心静脉管道固定方法，比较两组患者的导管移位率、脱管率以及固定天数。结果 实验组的导管移位率、由固定不牢固导致脱管的发生率低于对照组，固定天数长于对照组（P<0.05）。结论 胶带+棉线固定中心静脉导管方法的牵固性明显优于“人”型固定导管连接座并交叉固定输液连接座中心静脉管道固定法，具有临床推广价值。

[关键词]中心静脉导管；固定方法；应用成效

[中图分类号] R472 [文献标识码] A [文章编号] 1674-4721（2018）5（b）-0145-03

Fixation methods and application efficacy of improvement of central venous catheter in ICU patients

JIANG Chang-ying HUANG Xin-wu WANG Feng-juan

Intensive Care Unit，Zhangmutou Hospital of Dongguan City in Guangdong Province，Dongguan 523633，China

[Abstract]Objective To explore the application effect of adhesive tape and cotton on fixing central venous catheter in intensive care unit （ICU） patients.Methods From July 2014 to December 2015，120 patients with indwelling central venous catheter in ICU ward of our hospital were selected as the control group.From January 2016 to June 2017，120 patients with indwelling central venous catheter in ICU ward of our hospital were selected as the experimental group.The fixation of fixed catheter connector of “Ren” type in a Chinese character with cross-fixed infusion connector was used in the control group，while in the experimental group，adhesive tape and cotton thread for fixing central venous catheter was adopted.The catheter displacement rate，tube detached rate and fixed time were compared between the two groups.Results In the experimental group，the rate of catheter displacement was lower than that in the control group，the incidence of tube detached due to unstable fixation was lower than that in the control group，the fixed time was longer compared to that in the control group （P<0.05）.Conclusion Adhesive tape+cotton central venous catheter fixation is significantly better than that by fixed catheter connector of “Ren” type in a Chinese character with cross-fixed infusion connector，which has a clinical value for promotion.

[Key words]Central venous catheter；Fixation；Application efficacy

中心靜脉导管作为ICU危重患者输液的重要途径之一，需要连接多个三通管和多条延长管、输液管，承受较大的重力牵拉，胶布及贴膜容易松脱，常常出现置管深度变化、敷料开胶等现象[1]。中心静脉置管发生非计划拔管，将严重影响抢救和治疗的进行，并给患者带来伤痛和经济损失[2]。为降低中心静脉管道非计划性拔管的发生，我院从2016年1月起改进管道固定方法，取得良好效果，现将方法及结果报道如下。

1资料与方法

1.1一般资料

选取2014年7月～2015年12月我院ICU病房留置中心静脉管道的120例患者作为对照组，选取2016年1月～2017年6月我院ICU病房留置中心静脉管道的120例患者作为实验组。纳入标准：患者及家属签署知情同意书，同时获得医院医学伦理委员会批准。对照组中，男70例，女50例；……