PICC技术在恶性肿瘤化疗中的应用及护理

目的 总结恶性肿瘤患者化疗中经外周静脉置入中心静脉导管(PICC)的护理。方法观察并总结231例患者置管过程中发生的护理问题,采取相应的护理措施。结果 225例置管成功,其中一次置管成功217例、复位成功6例、穿刺困难2例(请麻醉科行颈内静脉置管),导管送入困难6例。PICC导管留置时间7～290 d,平均112.40 d;发生静脉炎14例,导管堵塞17例,穿刺点出血8例,单纯性肢体肿胀2例,导管滑出1例。结论熟练掌握PICC穿刺和维护技能,实施优质护理和健康教育,可显著降低PICC导管使用过程中发生的并发症,提高护理质量。

Application and Nursing of PICC in Chemotherapy of Malignant Tumor

Objective:To summary the application and nursing experience of PICC of patients with malignant tumor during chemotherapy.Methods:We adapted appropriate measures when various nursing problems occurred in 231 malignant tumor cases with the use of PICC catheter treatment.Results:The success cases of intubation of PICC were 225:The one time success cases were 217.Successful resetting of catheter after PICC dislocation cases were 6;Catheter indwelling problems cases were 2,which were solved by department of anesthesiology through internal jugular vein catheterization.Difficulties in advancing catheters cases were 6.The indwelling time of intubation was 7~290 d,mean 112.4 d.The catheter problems in the process were:phlebitis in 12 cases,the catheter blockage in 17 case,the puncture site bleeding in 8 cases,the simple swelling of limb in 2 cases;slid off in 1 case.Conclusion:Applying PICC of patients with malignant tumor during chemotherapy is not only safe,but also high successful rate of catheterization and long dwelling time of catheter.Mastering skillfully of the PICC technology and implementing high-quality nursing and health education can reduce PICC complications and improve the quality of nursing.