摘要
目的总结1例肠瘘患者长期应用经外周血管置入中心静脉导管（PICC）的护理方法，探讨8根导管在1例肠瘘患者应用中的护理经验和教训。方法对1例应用8根PICC的患者运用护理程序进行系统整体护理，观察其临床应用效果。结果8根导管留置时间最短3个月，最长14个月。第1、3、5、7根导管分别应用12、13、11、14个月，第1根由于经验不足，严格按照说明书导管留置时间拔管，第3根由于滴入不畅拔管，第5根患者强烈要求拔管，第7根则是患者洗头时不慎拔管；第2根导管留置6个月时患者体温升高达38．7℃，考虑为导管原因拔管，因缺少经验未作培养，拔管后患者体温恢复正常；第4根导管使用3个月时患者体温39℃，考虑导管相关性血流感染，拔出导管，尖端培养为真菌阳性；第6根留置7个月，由颈内静脉穿刺到上腔静脉，拔管原因是穿刺点局部化脓；第8根应用了8个月，拔管原因是堵管，应用尿激酶溶栓效果不佳。结论对肠瘘患者应用PICC可减轻患者痛苦，充分提高生活质量。
Objective To summarize our experiences in the long-term continuous maintenance of the peripherally inserted central catheter （PICC） in a patient with intestinal fistula. Method The systematic holistic nursing care has been provided according to the nursing practices to a patient with intestinal fistula since 2006, during which eitht PICCs were used successively. Results The eight PICCs were placed for 3-14 months. The 1 st, 3rd, 5th, and 7th cathers were retained for 12, 13, 11, and 14 months. The second catheter was retained for 6 months, and then removed due to increased body temperature （38.7℃）. The 4th cather was retained for 3 months, then catheter-related bloodstream infection was suspected due to high body temperature （39℃） ; culture for fungi at the tip showed positive results. The 6th catheter was retained for 7 months, inserting from jugular vein to the superior vena cava; however, it was removed due to puncture point local purulent changes at the puncture site. The 8th catheter was applied for 8 months, but was rmoved due to tube occlusion, which responded poorly to urokinase. Conclusion The application of PICC in patients with fistula can relieve the pain and improve the quality of life.
出处
《中华临床营养杂志》
CAS
CSCD
2013年第1期58-60,共3页
Chinese Journal of Clinical Nutrition
关键词
肠瘘
经外周血管置入中心静脉导管
护理
Intestinal fistula
Peripherally inserted central catheter
Nursing
