锁骨下静脉置管在专科护士中的应用

目的探讨锁骨下静脉置管在临床专科护士技能中的实用意义。方法1028例肝胆、胃肠道疾病患者,因外周静脉穿刺困难,选用锁骨下静脉穿刺置管至上腔静脉,提供通畅的静脉通道,用以进行围手术期大量输液、输血、静脉营养、化疗、测量CVP等。结果一次成功置管999例,成功率97.2%,27例穿刺失败,失败率2.8%,并发气胸2例。置管时间14~90d。经临床护理观察,锁骨下静脉穿刺置管法可减轻病人的痛苦,固定好、不易脱出、不易感染、维持时间长,是一种可靠、实用、安全的置管方式。结论锁骨下静脉穿刺置管是临床抢救危重病人的有效重要措施,确保护理质量,同时能提高护理人员专科护理技能。

The Application of Subclavian Vein Catherization in Special Nurses

Objective To investigate the value of subclavian vein catherization in the clinic skill of nurses.Methods 1 028 patients with liver and gall or gastrointestinal diseases were applied for subclavian vein puncture and catherized in superior vena cava to administer plentiful liquid and blood transfusion, parenteral nutrition, chemotherapy and CVP measurement et al.Results 999 cases were successfully intubated and 27 cases failed including 2 cases with the complication of pneumothorax. The time of detainment were 14 to 90 days. From the observation of clinic nursing, this method was lenitive, deep-set, free-moving, credible and safe. The tubes were maintained for long time and had little opportunity for infection.Conclusion Subclavian vein catherization is a potent and important method to salvage deathful patients. It can ensure the nursing quality and improve the specific nursing ability of paramedic.