刘泽梅　　陈玉叶　　蔡海珍　　蒋慧玲

[关键词] PICC导管;体内断裂;原因分析;护理对策

[中图分类号] R472          [文献标识码] B          [文章编号] 1673-9701（2021）15-0183-04

Cause analysis and nursing countermeasure of 51 cases of PICC rupture in vivo

LIU Zemei1 CHEN Yuye2   CAI Haizhen1   JIANG Huiling3

1.Deep Vein Catheterization Center， Lishui Municipal Central Hospital in Zhejiang Province， Lishui   323000， China; 2.Department of Anorectal Vascular Surgery， Lishui Municipal Central Hospital in Zhejiang Province， Lishui   323000，China; 3.Department of Nursing， Lishui Municipal Central Hospital in Zhejiang Province， Lishui   323000， China

[Abstract] Objective To analyze the cause and nursing countermeasure of PICC （peripherally inserted central venous catheter） rupture in vivo. Methods A total of 102 patients with PICC rupture in vivo from January 2018 to May 2020 were taken as the research objects，and they were divided into the control group and the experimental group according to the random number table method. The control group was treated with conventional nursing，while the experimental group was treated with targeted nursing. The efficacy rates，incidences of complications and satisfactions of interventions on the two groups were analyzed. Results The total efficacy rate in the experimental group was 98.04%，which was higher than that of 86.27% in the control grou，with significant difference（P<0.05）; The incidence of complications in the experimental group was 3.92%，which was lower than that of 15.69% in the control group，with significant difference（P<0.05）; The total satisfaction in the experimental group was 92.16%，which was higher than that of 76.47% in the control group， with statistically significant differences（P<0.05）. Conclusion There are many reasons leading to PICC rupture in vivo in patients. Standardized training of nursing staff on PICC placement and catheter maintenance should be strengthened to actively and effectively prevent and control the occurrence of PICC rupture in vivo in patients，so as to better ensure the safety of patients.

[Key words] Peripherally inserted central venous catheter; Rupture in vivo; Cause analysis; Nursing countermeasure

經外周置入中心静脉导管（Peripherally inserted central venous catheter，PICC）具有操作简单、留置时间长、护理简单等特点，是一种有效、安全的静脉治疗通路[1]。但在实际对PICC应用的过程中，若护理不当，则较易引发导管断裂等并发症的情况，从而对PICC导管使用的时间造成影响，增加患者的经济负担及危险性。因此，加强PICC导管体内断裂相关原因的分析，并实施相应的护理对策，十分必要。常规护理干预在PICC导管体内断裂患者中的应用，虽然可获得一定的效果，但效果并不理想，随着研究的深入，发现针对性护理的应用有着一定的价值，其能够通过分析患者的具体情况，给予患者更加科学、个性化的护理干预，从而保证护理的质量。本研究主要对PICC导管体内断裂的原因及护理对策进行分析，现报道如下。

1 资料与方法

1.1 一般资料

以2018年1月至2020年5月PICC导管体内断裂患者102例为研究对象，采用分段随机法分为试验组和对照组，每组各51例。试验组男39例，女12例，年龄35～63岁，平均（49.56±6.39）岁，其中鼻咽恶性肿瘤10例，直肠恶性肿瘤13例，淋巴瘤13例，肺恶性肿瘤15例。对照组男40例，女11例，年龄33～62岁，平均（50.03±6.20）岁，其中鼻咽恶性肿瘤11例，直肠恶性肿瘤14例，淋巴瘤12例，肺恶性肿瘤14例。纳入标准：①PICC导管体内断裂;②年龄超过18岁。排除标准：①PICC导管体外断裂者;②语言沟通障碍者;③患者或家属无法配合者。两组基本资料比较，差异无统计学意义（P>0.05），具有可比性。

1.2 方法

对照组给予常规护理，即常规按照医嘱，给予患者用药等相关的护理，适当为患者讲解疾病有关的知识，对于患者存在的疑问耐心解答。试……