透明袜套用于经外周置入中心静脉导管置管后导管保护的临床研究

目的探讨经外周置入中心静脉导管(PICC)置管后患者的导管维护方法。方法将320例PICC置管后患者按照随机数字表法分为试验组和对照组各160例,试验组以透明袜套套在PICC更换敷贴及肝素帽的手臂上;对照组PICC更换敷贴后不采用其他保护措施,观察比较两组不良反应发生率、意外情况发生率及提前更换敷料率。结果两组均随访至穿刺后第21天,试验组发生皮疹2例(1.25%)、胶布松脱1例(0.6%);对照组发生皮疹2例(1.25%)、卷边13例(8%)、胶布松脱12例(7.5%)、导管滑出2例(1.25%),两组不良反应发生率比较(1.25%VS1.25%),差异无统计学意义(P0.05);意外情况发生率比较(0.6%VS16.75%),差异有统计学意义(χ2=26.46,P0.05);对照组有20例提前更换敷贴(12.5%),试验组仅1例提前更换敷贴(0.6%),差异有统计学意义(P0.05)。结论透明袜套用于PICC导管及肝素帽的维护,保护了敷贴、胶布及肝素帽,使其不易被外界的牵拉力拉松、脱落,延长了敷贴粘贴时间,减少了不良反应的发生。

Clinical study on transparent socks in protection of catheter after peripherally inserted central catheter

Objective To study the catheter maintenance method after peripherally inserted central catheters （PICC）.Methods A total of 320 patients were randomly assigned to study group （n=160） and control group （n=160）.In study group we used transparent socks on arms which needed to change dressings and heparin caps while didn＇t in control group.Then we observed the incidence of adverse effect,accident and dressing change in advance between two groups.Results After follow-up for 21 days,incidence of rash and drop of dressing occurred in 2 （1.25%） and 1 （0.6%） cases in study group,and in 2 （1.25%） and 12 （7.5%） cases in control group.In control group,crimping and drop of catheter occurred in 13 （8%） and 2 cases （1.25%）.Incidence of adverse reactions between study group and control group showed no significant difference （1.25% vs.1.25%,P0.05）,unexpected situations showed significant difference （0.6% VS 16.75%,P0.05） and dressing change showed significant difference （0.6% VS 12.5%,P0.05）.Conclusion Transparent socks for the maintenance of catheter and heparin caps can protect dressing and heparin cap from dropping to prolong the time of dressing sticking to skin and reduce the incidence of adverse reactions.