梁群好 朱志辉 李燕钰 林平珍

【摘要】 目的：观察PDCA循环管理模式在儿童矮小症精氨酸激发试验留置针采血中的应用效果，为临床管理提供依据。方法：选取2018年1月-2019年12月在本院行精氨酸激发试验留置针采血的50例矮小症患儿为研究对象。按照随机数字表法将所有患儿分为研究组与对照组，每组25例。对照组在操作过程中采取常规管理，研究组在对照组的基础上采取PDCA管理措施。比较两组患儿血液标本的质量、抗凝血标本凝固情况、并发症发生情况及患儿与家属的护理满意度。结果：研究组患儿总溶血率、总体凝固率、并发症发生率均明显低于对照组，差异均有统计学意义（P<0.05）。研究组患儿与家属的满意度明显高于对照组，差异有统计学意义（P<0.05）。结论：PDCA循环管理模式能够有效降低儿童矮小症精氨酸激发试验留置针采血溶血的发生率，值得临床推广应用。

【关键词】 儿童矮小症 精氨酸激发试验 PDCA循环管理模式 留置针 采血器 溶血率

[Abstract] Objective： To observe the application effect of PDCA circulation management mode in blood collection with indwelling needle for arginine stimulation test in children with short stature， and to provide basis for clinical management. Method： A total of 50 children with short stature who underwent arginine stimulation test and indwling needle blood collection in our hospital from January 2018 to December 2019 were selected as the research objects. All the children were divided into study group and control group according to random number table method， 25 cases in each group. The control group took routine management during operation， and the research group took PDCA management measures on the basis of the control group. The quality of blood samples， coagulation of anticoagulant blood samples， incidence of complications and nursing satisfaction of children and their families were compared between the two groups. Result： The total hemolysis rate， total coagulation rate and incidence of complications in the study group were significantly lower than those in the control group， the differences were statistically significant （P<0.05）. The satisfaction of children and their families in the study group was significantly higher than that in the control group， the difference was statistically significant （P<0.05）. Conclusion： PDCA cycle management mode can effectively reduce the incidence of hemolysis in children with short stature by arginine stimulation test， and it is worthy of clinical promotion and application.

[Key words] Children with short stature Arginine challenge test PDCA cycle management mode Indwelling needle Blood sampler Hemolysis rate

靜脉留置针是临床上一种简单的操作手法、是一种可以较长时间留置的输液工具，在临床上被广泛应用，也常运用于儿童患者[1]。近年来随着检验学的发展，血液化验的相关检查项目增多，所需血液抽取的样本也随之增多。反复的穿刺不仅会对患者的血管与周围组织造成损伤，还会增加发生感染的风险以及患者的痛苦;压迫不当与穿刺失败导致的血肿在很大程度上增加了再次穿刺的难度;采血时间的不准，血管条件不佳在很大程度上加大了穿刺难度，这均会影响结果的精准性[2]。目前，临床对于通过静脉留置针采血是否对患儿血液标本的质量产生影响还存在着较大的争议，若存在影响则可能会导致标本质量不合格的情况出现[3]。……