简介:摘要目的通过观察PICC与颈内静脉置管肿瘤患者的同种导管维护方法,比较两种置管在静脉化疗中的应用效果,探讨如何减少再次静脉穿刺机率及并发症发生率等,提高肿瘤患者生存质量。方法将50例确诊为肿瘤需行静脉化疗的患者分成两组,外周静脉显露者优先列为实验组,另外25例为对照组,分别观察同种导管维护方法,对两种置管留置时间、舒适度和并发症的比较。结果实验组留置时间为102-362天,平均150天,对照组留置时间为27-92天,平均51天。观测发现,实验组病人留置时间、舒适度远远高于对照组(P<0.05),并发症的发生率低于对照组(P<0.05),意义重大,效果显著。结论在恶性肿瘤患者中选用PICC明显优于颈内静脉置管,值得临床推广。
简介:摘要目的探讨血液透析患者股脉置管术后血栓形成的相关因素,并提出护理策略.方法研究对象是随机抽取我院2012年5月至2014年4月收治的208例血液透析患者,行股静脉置管术后4周观察超声诊断结果,并将其分为血栓组与非血栓组,分析其形成因素并制定护理策略.结果208例行股静脉置管术后,导管周围血栓共9例,占4.32%,静脉管腔内血栓充填共8例,占3.84%,静脉管腔壁血栓共8例,占3.84%,静脉血栓形成伴狭窄共7例,占3.36%,股静脉血栓形成共32例,占15.38%,股静脉血栓未形成占176例;32例术后静脉血栓形成的患者中,主要因素为导管留置时间长因素共11例,占34.38%,血清胆固醇高共10例,占31.25%,共5例,血浆白蛋白低占15.63%,导管感染共4例,占12.5%,无肝素或肝素减量透析者2例,占6.24%,以上因素与对照组比较均有统计学差异(P<0.05).结论血液透析患者股静脉置管术后血栓形成概率较高,其中导致术后血栓形成的因素有管留置时间长、血清胆固醇高、低蛋白血症、导管感染、无肝素后肝素减量透析等.临床应引起重视,术后积极进行相关护理,结合超声检查,避免血栓形成.关键词血液透析;股静脉置管;血栓;危险因素;护理措施;Abstractobjectivetostudythefemoralveincatheterhemodialysispatientspostoperativethrombosisrelatedfactors,andputforwardthenursingstrategy.MethodstheresearchobjectisrandomlyselectedfromMay2012toApril2014treated208casesofhemodialysispatients,lineoffemoralveincatheterafter4weekstoobservetheultrasonicdiagnosis,anditcanbedividedintothrombosisandthrombosisgroup,analyzestheformingfactorsandnursingstrategy.Results208routinevenipuncturesurgery,catheterthrombosissurroundingatotalof9cases,accountedfor4.32%,8casesofvenouslumenthrombosisinfilling,accounGtedfor3.84%,8casesofvenouslumenatherothrombosis,accountedfor3.84%,venousthrombosisassociatedwithstenosisinall7cases,accountedfor3.36%,femoralveinthrombosis,atotalof32cases,accountedfor15.38%,accountedfor176casesoffemoralvenousthrombosisdidnotformation;32casesofpostoperGativevenousthrombosispatients,themainfactorsforcatheterindwellingtimeislong,atotalof11cases,accountingfor34.38%,serumcholesterollevels,atoGtalof10cases(31.25%),andatotalof5cases,lowplasmaalbumin(15.63%),catheterinfectionin4cases,accountedfor12.5%,withoutheparinorheparinondialysisin2cases,factorsaccountedformorethan6.24%,comparedwiththecontrolgroupwerestatisticallysignificant(P<0.05).Conclusionhemodialysispatientspostoperativefemoralveincatheterthrombosisprobabilityishigher,thecausingfactorsofpostoperativethrombosishavelongtubeindwellingtime,highserumcholesterol,hypoalbuminemia,catheterinfection,noheparindoseheparinafterdialysis,etc.Weshouldpayattentiontotheclinical,positivelyrelatedtonursinkgeycarweor,dpsostoperativecombinedwithultrasound,preventthrombosis.hemodialysis;Venipuncture;Bloodclots.Riskfactors;Nursingmeasures;中图分类号R472文献标识码B文章编号1008-6315(2015)12-0812-01