李汉芬 麻玲霞 唐江艳 李燕

【摘要】 目的：探讨居家维护方式的可行性，为制定适用于本区经外周静脉置入中心静脉导管（PICC）带管患者居家维护的操作流程提供理论基础。方法：选取2017年6月-2018年6月在笔者所在医院肿瘤内科住院治疗的84例肿瘤PICC带管出院患者。根据患者护理意愿分为居家护理组及返院护理组。剔除死亡和失访患者，居家护理组26例，返院护理组55例，比较两组的并发症发生率。结果：返院护理组中，发生导管脱出1例（1.81%）、深静脉血栓10例（18.18%）、穿刺点感染7例（12.72%）、过敏性皮炎8例（14.55%），无患者出现导管堵塞及导管相关性血流感染;居家护理组中，发生导管脱出2例（7.69%）、导管相关性血流感染1例（3.84%）、深靜脉血栓5例（19.23%）、穿刺点感染4例（15.38%）、过敏性皮炎3例（11.54%），无患者出现导管堵塞及导管相关性血流感染。两组各导管并发症发生率比较，差异均无统计学意义（P>0.05）。结论：对于PICC带管出院患者，居家维护模式是可行的。

【关键词】 PICC 返院维护 居家维护 并发症

doi：10.14033/j.cnki.cfmr.2019.28.033 文献标识码 B 文章编号 1674-6805（2019）28-00-02

Feasibility on Home Maintenance Mode of PICC Catheter for Discharged Patients with Tubes/LI Hanfen， MA Lingxia， TANG Jiangyan， LI Yan. //Chinese and Foreign Medical Research， 2019， 17（28）： -82

[Abstract] Objective： To explore the feasibility of home maintenance methods， and to provide theoretical basis for establishing the operation process suitable for home maintenance of peripheral central catheterization （PICC） patients in our district. Method： A total of 84 cases of tumor patients discharged with PICC from June 2017 to June 2018 were selected. According to the patients nursing wishes， they were divided into home nursing group and back-to-hospital nursing group. After excluding the dead and lost patients， there were 26 cases in the home nursing group and 55 cases in the back-to-hospital nursing group. The incidence rate of complications were compared between the two groups. Result： In the back-to-hospital nursing group， catheter prolapse occurred in 1 case （1.81%）， deep vein thrombosis occurred in 10 cases （18.18%）， puncture point infection occurred in 7 cases （12.72%）， allergic dermatitis occurred in 8 cases （14.55%）， no catheter blockage and catheter-related bloodstream infection occurred in the patients.In the home nursing group，catheter prolapse occurred in 2 cases （7.69%）， catheter-related bloodstream infection occurred in 1 case （3.84%）， deep vein thrombosis occurred in 5 cases （19.23%）， puncture point infection occurred in 4 cases （15.38%）， allergic dermatitis occurred in 3 cases （11.54%）， and there was no catheter blockage and catheter-related bloodstream infection in patients.There were no significant differences in the incidence of all catheter complications between the two groups （P>0.05）. Conclusion： Home maintenance mode is feasible for discharged patients with PICC.

[Key words] PICC Back-to-hospital maintenance Home maintenance Complications

First-authors address： First Affiliated Hospital of Guangxi Medical University， Nanning 530021， China

经外周静脉置入中心静脉导管（PICC）是一种并发症发生率低的中心静脉通路，可为肿瘤患者提供中长期化疗静脉通路[1]。患者在接受化学治疗的间歇期需要带管出院，维护方式目前主要以返院维护为主，但广西PICC维护点还局限在二级甲等以上的医院，覆盖面较小，不能满足所有带管患者的维护需求。居家维护是指PICC带管患者出院期间，由患者及其家属或其他照护人员在家中独立进行PICC导管维护的方式[2-3]。对于部分患者而言，居家维护是较好的选择，因此，本文旨在通过比较居家维护方式与返院维护方式的并发症发生率，探讨居家维护方式的可行性，为制定适用于本区PICC带管患者居家维护的操作流程提供理论基础。