静脉留置针输液过程中的常见问题分析与护理对策

目的：总结静脉留置针输液过程的常见问题,制定针对性护理对策。方法：选取本院住院期间应用静脉留置针进行输液治疗的120例患者,观察静脉留置针的留置时间、穿刺部位、液体性质、封管液及封管方式与常见问题的关系。结果：静脉炎发生率,静脉留置针留置5d以上（55%）明显高于5d以内;以关节活动部位为穿刺点明显高于非关节部位;静滴等渗液体明显低于静滴高渗液体,差异均有统计学意义（P〈0.05）。关节部位的留置针发生液体渗漏的机会明显高于非关节活动部位;采用0.9%氯化钠注射液＋肝素盐水稀释液进行封管,其发生留置针导管堵塞的机会明显低于单用;采用正压封管的患者,其留置针导管堵塞的发生率明显低于采用负压封管,差异均有统计学意义（P〈0.05）。结论：正确选择穿刺部位、熟练运用穿刺技术、合理应用封管方式能够最大限度地降低静脉留置针输液过程中的问题发生率。

Analysis of the Common Problems and Nursing Countermeasures in Transfusion Process of Venous Indwelling Needle

Objective：To summarize the common problems in transfusion process of venous indwelling needle,and to develop strategies for nursing care.Method：120 patients used venous indwelling needle in our hospital were selected randomly. The indexes of retaining time of intravenous indwelling needle,choice of the puncture site,the liquid nature,the interaction of different sealing liquid and different sealing methods in the infusion process were observed and recorded.Result：The rate of occurrence of phlebitis reached to 55% when venous indwelling needle for more than 5 days,it was significantly higher than that within 5 days（P 0.05）.The incidence of phlebitis were significantly higher than those in non joint puncture point（P 0.05）. The incidence of phlebitis of intravenous infusion of isotonic fluids was significantly lower than that of intravenous infusion of hypertonic liquid（P 0.05）. To the joint needle,the opportunity of infusion leakage occurring during fluid infusion was significantly higher than that of joint parts of the indwelling needle（P 0.05）.Conclusion：Based on the puncture site selection,puncture technique,skilled use of sealing methods of reasonable application and appropriate health education,it can minimize the occurrence of common problem transfusion process of venous indwelling needle.