ICU患者中心静脉导管敷料更换原因及护理方法的探讨

目的：观察ICU患者中心静脉导管敷料的更换原因，探讨改进ICU患者中心静脉导管敷料护理方法。方法对常规组299例中心静脉留置导管患者敷料更换原因进行回顾性分析，运用整体护理方法设计并实施针对中心静脉导管敷料更换的套餐护理措施，选择次年同期采用该护理措施的289例患者为套餐组进行比较。结果 ICU患者中心静脉导管敷料更换的原因有贴膜松脱、渗血、渗液；常规组敷料维持天数为（2．35±0．89）d，低于套餐组的（3．43±0．52）d（P＜0．05）；常规组中心静脉导管相关血流感染（CRBSI）率为13．0％，高于套餐组的7．2％，差异有统计学意义（P＜0．05）。结论正确的护理措施可以切实提高中心静脉患者敷料维持天数，降低中心静脉导管相关血流感染率。

Exploration of the reasons for the replacement of central venous catheter dressing in ICU patients and their proper care

Objective To explore the reasons for the replacement of central venous catheter dressing and improve nursing in ICU patients.Methods Retrospective analysis was made on the reasons for the replacement of central venous catheter dressing in patients of the conventional group .By using integrated nursing method ,＂menu-care＂;procedures were designed and implemented for the replacement of central venous catheter dressing, and patients applying the same nursing methods in the same period next year were used as the control.Results The reasons for the replacement of central venous catheter dressing in ICU patients were： looseness of the adhesive membrane, oozing of blood and oozing of fluid.Days of dressing maintenance for the conventional group were（2.35 ± 0.89）d, which were obviously fewer that those of the ＂menu-care＂group （3.43 ±0.52） d, with statistical significance（P〈0.05）.CRBSI of the conventional group was 13.0%, which was higher than that of the ＂menu-care＂group, also with statistical sig-nificance（P〈0.05）.Conclusion Proper nursing methods could increase the days of dressing maintenance and decrease the infection rate of CRBSI .