精准护理在避免肿瘤患者经外周静脉留置中心静脉导管置管并发症发生的效果及相关影响因素分析

目的分析精准护理在避免肿瘤患者经外周静脉留置中心静脉导管(peripherally inserted central catheter,PICC)置管并发症的效果及相关影响因素。方法选取2016年5月-2020年5月于宝山区吴淞中心医院进行PICC置管的186例肿瘤患者作为研究对象,根据入院时间不同采用简单随机化分组,将患者分为对照组和试验组,每组93例。其中对照组给予常规护理,而试验组则针对可能导致PICC置管并发症发生的致病因素制定精准护理方案。对比2组置管及住院时间、并发症发生情况、患者心理状态及护理满意度,并探讨导致并发症发生的危险因素。结果与对照组比较,试验组平均住院时间、平均住院费用、PICC置管后并发症总发生率及HAMA评分均降低,置管时间延长,患者护理满意度升高,且差异均有统计学意义(P<0.01)。经Logistic回归分析结果显示,病程分期(Ⅲ~Ⅳ期)和有无无菌操作是PICC并发症发生的独立危险因素(P<0.01)。结论精准护理在保证肿瘤患者PICC置管时间的基础上,可降低并发症发生率,有效改善患者心理状态和对护理人员满意度,具有一定推广价值。

Effect of precise nursing on prevention of complications of PICC catheterization in tumor patients and analysis of related influencing factors

Objective To analyze the effect of precision nursing on prevention of complications of peripherally inserted central catheter(PICC)catheterization and related influencing factors in tumor patients.Methods One hundred and eighty-six tumor patients who underwent PICC catheterization at Wusong Central Hospital of Baoshan District from May 2016 to May 2020 were recruited as the research subjects.According to the admission time,the patients were randomly divided into control group and experimental group,93 cases in each group.The control group was given routine nursing,while the experimental group was given precise nursing according to the pathogenic factors that may lead to PICC catheter complications.The catheterization and hospitalization time,complications,psychological status and nursing satisfaction were compared between the two groups,and the risk factors of complications were discussed.Results Compared with the control group,the average hospitalization time,average hospitalization expenses,the total incidence of complications of PICC catheterization and HAMA score of the experimental group were decreased,the catheterization time was prolonged,and the nursing satisfaction of patients was increased,and the differences were statistically significant(P<0.01).Logistic regression analysis showed that stage of disease(stageⅢ~Ⅳ)and aseptic operation were the independent risk factors for PICC complications(P<0.01).Conclusion On the basis of ensuring the PICC catheter time of tumor patients,precision nursing can reduce the incidence of complications,effectively improve the psychological state and the nursing satisfaction of patients,which has a certain promotion value.