雷彦俊　蒋慧玲 吕魏潇　刘泽梅

[摘要] 目的 探討自我管理项目干预在经外周静脉穿刺中心静脉置管（PICC）下鼻咽癌（NPC）家庭中的应用价值。 方法 选择2018年2月至2020年2月在我院行PICC置管的70例NPC患者，其中35例患者及其家属均接受常规的健康宣教（对照组），35例患者及其家属则实施自我管理干预（观察组），比较两组患者对PICC相关知识的掌握情况、患者及家属的自我护理能力、负面情绪及并发症情况。 结果 干预后，观察组患者对PICC相关知识掌握程度明显高于对照组（P<0.05）;观察组各项自我护理能力评分均明显高于对照组（P<0.05）;且观察组干预后的焦虑状态评分明显低于对照组（P<0.05）;观察组PICC并发症的总发生率明显低于对照组（P<0.05）。 结论 将自我管理项目干预应用于PICC置管下的鼻咽癌家庭中，可有效提高患者家庭对相关知识的掌握程度及自我护理能力，同时缓解其焦虑情况，且对各项并发症的发生也具有较好的预防效果。

[关键词] 经外周静脉穿刺中心静脉置管;自我管理项目干预;鼻咽癌;自我护理能力;负面情绪

[中图分类号] R473.7          [文献标识码] B          [文章编号] 1673-9701（2021）06-0178-04

Effect of self-management program on self-care ability and anxiety state of nasopharyngeal carcinoma patients with PICC and their family members

LEI Yanjun   JIANG Huiling   LYU Weixiao   LIU Zemei

Department of Radiotherapy， Lishui Municipal Central Hospital in Zhejiang Province， Lishui   323000， China

[Abstract] Objective To explore the application value of self-management program in nasopharyngeal carcinoma （NPC） patients with peripherally inserted central venous catheters （PICC） and their family members. Methods A total of 70 NPC patients underwent PICC in our hospital from February 2018 to February 2020 were selected. 35 patients and their families received routine health education（the control group）， while the other 35 patients and their families received self-management intervention（the observation group）. The mastery of PICC related knowledge， self-care ability of patients and their families， negative emotions and complications were compared between the two groups. Results After the intervention， the patients in the observation group had a significantly better master of PICC related knowledge than the control group（P<0.05）. The scores of self-care ability of patients and their families in the observation group were significantly higher than those in the control group（P<0.05）. The anxiety scores of the families in the observation group after intervention were significantly lower than those in the control group（P<0.05）. In addition， after observation and statistics， it was found that the total incidence of PICC complications in the observation group was significantly lower than that in the control group（P<0.05）. Conclusion For NPC patients with PICC and their family members， the self-management program can effectively improve their mastery of relevant knowledge and self-care ability， relieve their anxiety，and have a good preventive effect on the occurrence of various complications.

[Key words] Peripherally inserted central venous catheters; Self-management project intervention; Nasopharyngeal carcinoma; Self-care ability; Negative emotion

经外周静脉穿刺中心静脉置管（Peripherally inserted central venous catheters，PICC）是临床较为常用的输液手段，可利用导管从患者的外周手臂处静脉进行穿刺，沿血管直达上腔静脉[1]，不仅有效避免了药物与手臂静脉的直接接触，且操作简单、维护方便、留置时间长，已广泛应用于各种疾病的治疗方案中[2]。鼻咽癌（Nasopharyngeal carcinoma，NPC）是临床常见的耳鼻咽喉科恶性肿瘤疾病，多以化疗作为该病的主要治疗方式，而PICC置管已成为鼻咽癌患者实施化疗的重要途径[3]。但鼻咽癌患者的治疗疗程通常较长，大部分患者需在化疗间隙自行回家休养，在此过程中，由于患者及家属对导管维护知识及自我护理能力的缺乏，极易导致各种并发症的发生，不仅影响患者的治疗效果，且增加临床治疗成本，不利于化疗方案的持续进行[4]。对此，为了提高患者对PICC导管的维护能力，本文将自我管理项目这一干预方案应用到PICC的鼻咽癌家庭中，并对其应用价值进行分析，现报道如下。……