4例肿瘤患者PICC并发血栓形成的临床观察与护理对策

目的探讨留置经外周静脉置入中心静脉导管(PICC)肿瘤患者并发血栓形成的最佳护理对策。方法对患者进行临床观察,对4例并发血栓形成的患者进行分析分类,2例上肢肿胀、疼痛患者经彩超诊断为静脉血栓,2例患者导管外露部分肉眼可见明显回血,导管腔完全阻塞,无上肢疼痛、肿胀,判断为导管内血栓。结果 2例静脉血栓患者予拔管,经溶栓、抗凝治疗,患肢肿胀、疼痛消失;另2例患者导管内血栓经溶栓处理后管腔再通,继续使用,随访观察,无其他部位栓塞症状。结论 PICC并发血栓形成要预防在前,早发现,早治疗,科学护理,以确保PICC留置的安全性,延长留置时间。

Clinical observation and nursing countermeasures for 4 cancer patients with PICC and thrombosis

Objective To explore the best nursing countermeasures for PICC and cancer patients with thrombosis.Methods 4 cancer patients with thrombosis were observed,analyzed and categorized.2 patients had swelling and pain of upper limbs,and they were diagnosed as phlebothrombosis.Blood backflow were seen in the exposed part of catheter in the other 2 patients,the catheter cavity was absolutely obstructed,and the patients had no sense of pain and swelling in upper limbs,so they were diagnosed as intraductal thrombosis.Results The 2 phlebothrombosis patients received extubation solution,and their sense of swelling and pain were disappeared after treatment of thrombolysis and anticoagulation.The symptom of intraductal thrombosis in the other 2 patients was processed with thrombolysis solution,and the catheter could be used again.With follow-up observation,no patient had thrombosis in other position.Conclusion PICC combined with thrombosis can be prevented.Early detection,early treatment and scientific nursing can ensure the safety of indwelling PICC and prolong the indwelling duration.