摘要
目的探讨超声引导下成人患者采用改良赛丁格技术经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)后的最佳首次换药时间。方法选取2016年7月至2018年6月在安徽医科大学第二附属医院肿瘤科接受超声引导下改良赛丁格技术置入PICC导管患者150例,依据其术后首次换药时间的不同分为对照组和试验组。对照组患者首次换药时间为置管后24h;试验组又分为试验一组和试验二组,试验一组的首次换药时间为置管后48h,试验二组的首次换药时间为置管后72h。比较分析3组患者在首次换药后24h内的切口出血情况、置管后首次换药的不良反应发生情况以及换药后置管侧上肢的疼痛程度。结果 3组患者中,对照组的切口出血率最高(P<0.05),其次为试验一组(P<0.05);3组患者的不良反应发生情况经比较差异无显著性(P>0.05);3组患者在首次换药后均存在不同程度的疼痛,其中对照组患者的疼痛程度明显高于试验组(P<0.05)。结论在置管后72h进行首次换药有利于减少切口出血并且降低患者的疼痛感,但首次换药时间对不良反应的发生率影响较小。
Objective To study and analyze the first best dressing change time of ultrasound-guided adult patients after modified PICC stent implantation. Method 150 patients with PICC catheterization were implanted under the guidance of ultrasonic guidance in our hospital from July 2016 to June 2018. According to the difference of the first change time after the operation, the first change time of the control group was 24 hours after the replacement of the tube. The patients in the experimental group were divided into two groups.The first one in the experimental group, the time of dressing change was 48 hours after catheterization.And the first dressing time of two in the experimental group was 72 hours after catheterization. Analysis and comparison of three groups of patients in 24 hours after change in the bleeding situation, and compare the three groups of patients after the first change after the replacement of the drug adverse reaction, analysis and comparison of the three groups of patients after the replacement of the tube side of the upper limb pain degree. Result Among the three groups, the bleeding rate of the control group was the highest(P<0.05), followed by the experimental group, the two bleeding rate in the experimental group was significantly lower than that in the control group and the experimental group(P<0.05), and there was no significant difference in the occurrence of adverse reactions between the three groups(P>0.05);the three groups were all present after the first change. Different degrees of pain, the pain level of the control group was significantly higher than that of the experimental group(P<0.05). Conclusion The first 72 hours after catheterization can effectively reduce the rate of incision bleeding, and have less effect on the incidence of adverse reactions, and can also reduce the pain of the patients to the greatest extent. Therefore, the best time for dressing change after catheterization is 72 hours after operation.
作者
马玉君
李小林
方玉翠
程怀东
MA Yu-jun;LI Xiao-lin;FANG Yu-cui;CHENG Huai-dong(Department of Oncology, Second Affiliated Hospital of Anhui Medical University, Anhui Hefei 230601, China)
出处
《中国医刊》
CAS
2019年第4期451-454,共4页
Chinese Journal of Medicine
基金
国家自然科学基金(81372487)
关键词
超声引导
改良赛丁格技术
经外周静脉置入中心静脉导管
置管
换药时间
Ultrasound guided
Modified Sedinger technique
Peripherally inserted central catheter
Catheterization
Dressing time
