集束化干预在老年肿瘤患者经外周静脉穿刺中心静脉置管中的应用

Application of cluster intervention in peripherally inserted central catheter catheterization in elderly tumor patients

中文关键词: 老年  肿瘤  集束化干预  经外周静脉穿刺中心静脉

英文关键词: elderly  tumor  cluster intervention  central venous puncture through peripheral vein

中文摘要:

      目的 探讨集束化干预在老年肿瘤患者经外周静脉穿刺中心静脉置管(central venous catheterization through pe-ripheral venous puncture,PICC)中的应用.方法 回顾性分析2021 年10 月—2022 年 10 月在三六三医院收治的首次行PICC置管的135 例老年肿瘤患者的临床资料,根据不同干预方法将其分为观察组(n =94)和常规组(n =41).观察组采取集束化干预,常规组患者给予常规干预.观察并比较2 组PICC情况(时长、穿刺次数),干预期间并发症[置管部位医用粘胶剂相关性皮肤损伤(MARSI)、导管局部感染、相关血栓形成、静脉炎和非计划拔管]发生情况,以及干预结束后患者的护理满意度和舒适度评分;采用健康调查量表SF-36 评分评价并比较2 组患者干预前后的生活质量水平.结果 与常规组比较,观察组1 次穿刺成功率升高,PICC导管留置时长增加,差异均有统计学意义(P＜0.05);干预期间,观察组总并发症发生率低于常规组(P＜0.05);干预后,观察组护理满意度评分、舒适度评分、SF-36 各维度评分及其干预前后差值绝对值均高于常规组(P＜0.05).结论 集束化干预技术应用于老年肿瘤患者的PICC置管,优势明显,有助于降低置管后并发症的发生率,提高首次穿刺成功率,延长置管时间,并改善患者的舒适度和满意度,具有一定的临床应用价值.

英文摘要:

      Objective To explore the application of cluster intervention in peripherally inserted central catheter(PICC)catheterization in elderly tumor patients.Methods The clinical data of 135 elderly tumor patients who received PICC catheter-ization for the first time in Hospital 363 from October 2021 to October 2022 were retrospectively analyzed.According to differ-ent intervention methods,they were divided into routine group(n =41)and observation group(n =94).The observation group received cluster intervention,while the routine group received routine intervention.The PICC situation(duration,num-ber of punctures),the incidence of complications[medical adhesive related skin injury(MARSI)at the catheterization site,catheter local infection,related thrombosis,phlebitis and unplanned extubation]during the intervention,as well as the nursing satisfaction and comfort scores of patients after the intervention were observed and compared between the two groups.The MOS 36-Item Short Form Health Survey(SF-36)was used to evaluate and compare the quality of life of the two groups before and after the intervention.Results Compared with the routine group,the success rate of one puncture increased in the observation group,and indwelling time of PICC prolonged,with statistical significance(P＜0.05).During intervention,total incidence of complications in the observation group was lower than that in the routine group(P＜0.05).After intervention,the nursing sat-isfaction score,comfort score,SF-36 score in all dimensions,as well as their absolute differences before and after intervention in the observation group were higher than those in the routine group(P＜0.05).Conclusion The application of cluster inter-vention technology in PICC catheterization in elderly tumor patients has obvious advantages.It can help to reduce the incidence of complications after catheterization,improve the success rate of the first puncture,prolong indwelling time,and improve the comfort and satisfaction of patients.It has certain clinical application value.