摘要
目的总结PICU45例小儿中心静脉置管输注系统的围术期护理要点。方法对45例需中心静脉置管患儿于术前进行充分的评估,重视患儿及家属的心理护理,介绍中心静脉置管输注系统的特点和日常护理方法,消除患儿及家属的思想顾虑,协助完成相关的术前准备。术后密切观察患儿生命体征,中心静脉置管植入部位表面皮肤情况,疼痛管理,饮食管理,心理护理,标准化护理,常见问题处理,强化出院指导。结果本组45例接受中心静脉置管的患儿中右侧股静脉置管40例,左侧股静脉置管2例,右侧颈静脉置管2例,左侧肘静脉PICC1例,均无并发症发生,有10例患儿导管尖端细菌培养阳性,其中肺炎克雷伯菌1例,鲍曼不动杆菌2例,大肠埃希菌2例,屎肠球菌2例,表皮葡萄球菌1例,粪肠球菌1例,白色念珠菌1例。导管细菌培养阳性的患儿中血细菌培养均阴性。结论重症患儿进行中心静脉导管留置术具有维护简单、留置时间长、并发症少等特点,能够保证抢救药物及时输入。标准化的中心静脉置管输注系统的围术期护理、规范化的植入物跟踪能够保证患儿的安全,长时间中心静脉置管并没有导致导管相关血流感染的发生。
Objective To summarize the key points of perioperative nursing of 45 central venous inserted double lumen catheter in children of PICU.Methods The perioperative nursing included adequate perioperative evaluation,paying more attention to psychological nursing care for children and their families,introducing central venous inserted double lumen catheter characteristics and daily care,eliminating ideological concerns of children and their families,assisting relevant perioperative preparation.After surgery,children were under close observation of vital signs,the surface skin condition of the infusion port implanted,pain management,catering management,psychological care,standardization of nursing,treatment of common problems,enhanced education for discharge.Results All the cases were without complications.Among45 cases,40 cases central venous inserted double lumen catheter were at right femoral vein,2 cases at left femoral vein,2 cases at right jugular vein and 1 case at left ulnar vein.The top of catheter bacterial culture were positive in ten of the cases,the bacterias were Klebsiellar pneumonia（1 case）,baumanii（2 cases）,Escherichia coli（2 cases）,Enterococcus Faecium（2 cases）,Staphylococcus epidermidis（1 case）,Enterococcus faecalis（1 case）,Candida albicans（1 case）,but all the blood bacterial culture were negative.Conclusions standardized perioperative nursing of central venous inserted double lumen catheter in children of PICU can ensure patients＇ safety and improve the patients＇ quality of life,increase service quality and patients＇ satisfaction.
出处
《中国煤炭工业医学杂志》
2016年第1期137-139,共3页
Chinese Journal of Coal Industry Medicine
关键词
中心静脉置管
导管相关性血流感染护理
围术期
Central venous inserted catheter
Nursing care
Catheter related blood stream infection
Perioperation
