摘要
目的探讨血压计加压法预防PICC置管术后导管相关性静脉血栓形成的效果。方法将171例置入PICC导管的肿瘤患者随机分为2组,实验组86例,对照组85例。实验组于置入PICC导管24小时后施以血压计加压法,将袖带绑于置管处远心端,捏球囊加压将袖带压力快速加压至平均动脉压水平,维持5 s后放松5 s,重复操作50次为一组,早午晚和临睡前均操作一组,共4组/日。对照组于置入PICC导管24小时后进行握拳锻炼,嘱患者握紧拳头5 s后放松5 s,操作频率同实验组。观察两组患者置管60天内静脉血栓发生率、置管后第2天及第3天的穿刺点出血情况。结果实验组静脉血栓发生率为1.16%,对照组为7.05%,两组差异具有统计学意义(P<0.05)。两组患者置管后第2天及第3天的穿刺点出血情况差异无统计学意义(P>0.05)。结论血压计加压法可有效地预防PICC置管后静脉血栓形成,同时并未增加PICC置管后的穿刺点出血事件,临床应用安全有效。
Objective Explore the effect of compression with sphygmomanometer to prevent Catheter-related Venous thrombosis after PICC.Methods 171 patients with tumor after PICC were divided to two groups randomly:the treatment group(86)and the controlled group(85).The treatment group was accepted compression by sphygmomanometer 24 hours after PICC.The operation is as following:putting the cuff on the distal end of the puncture point,Elevating the pressure to the level of MAP,Keeping 5s and releasing rapidly,holding 5s and repeat 50 times for a group,4 groups per day.The control group was accepted the practice of clenching the fist 24 hours after PICC,the patients were told that clenching the fist for 5s and relaxing for 5s,repeat 50 times for a group,4 groups per day.The observation include that the occurrence rate of the venous thrombosis 60 days after PICC and the bleeding of the puncture point in 2 and 3 days after PICC.Results The occurrence rate of venous thrombosis in treatment group is 1.16%,as well as 7.05%in controlled group,which is statistically significant(P<0.05).The bleeding of the puncture point in 2 and 3 days after PICC is no difference between the two groups,which is not statistically significant(P>0.05).Conclusion Compression by sphygmomanometer after PICC is effective to prevent the occurrence of the venous thrombosis,and it is safe because it have not increase the bleeding event of the puncture point.
作者
朱冰珍
梁素芳
容健成
林玉珍
谭凤秀
ZHU Bingzhen;LIANG Sufang;RONG Jiancheng;LIN Yuzhen;TAN Fengxiu(The Jiangmen Central Hospital,Neurology Department,Guang Dong 529000,CHINA)
