循证护理预防ICU患者发生CVC相关性不良反应及非计划性拔管的效果观察

目的：：探讨循证护理在预防重症医学科( ICU)患者中心静脉导管( CVC)相关性不良反应及降低非计划拔管的护理效果。方法：选择符合标准的患者80例,采用随机数字表法分为观察组和对照组各40例,观察组实施循证护理,对照组实施常规护理,比较二者导管相关性不良反应及非计划性拔管情况。结果：观察组患者入住ICU时间(26.09±3.61)d及在ICU内CVC置管时间(25.37±3.42)d,对照组患者入住ICU时间(26.11±3.70)d及在ICU内CVC置管时间(25.40±3.49)d,差异无统计学意义(P>0.05)。观察组患者CVC相关性不良反应发生6例,发生率15.00％；对照组患者CVC相关性不良反应发生14例,发生率35.00％,差异有统计学意义( P<0.05)。观察组患者发生非计划拔管2例,发生率5.00％；对照组患者发生非计划拔管6例,发生率17.50％,差异有统计学意义( P<0.05)。结论：循证护理能有效预防ICU患者CVC相关性不良反应发生,降低非计划性拔管率,具有一定的临床应用价值。

Effects of Evidence-based Care in Prevention from PICC-associated Adverse Reactions and Unplanned Extubation in ICU Patients

Objective:To investigate the effects of evidence-based care in prevention from peripherally inserted central catheter ( CVC)-associated adverse reactions and unplanned extubation in intensive care unit ( ICU) patients. Methods:A total of 80 eligible patients were selected, and randomly divided into observation group and control group, with 40 patients in each group. The patients of the observation group were given evi-dence-based care, while the patients of the control group given usual care, and the CVC-associated adverse reactions and unplanned extubation were compared between the two groups. Results:The length of stay in ICU and that of CVC intubation in ICU of the patients of the observation group were (26.09±3.61) d and (25.37± 3.42) d, respectively;while those of the control group were (26.11±3.70) d and (25.40±3.49) d;and the differences were statistically insignificant (P>0.05). The incidences of CVC-associated adverse reactions of the observation group and the control group were 15.00% (6/40) and 35.00% (14/40), respectively, and the difference was statistically significant ( P<0.05) . The incidences of unplanned extubation of the observation group and the control group were 5.00% (2/40) and 17.50% (6/40), respectively, and the difference was statistically significant (P<0.05). Conclusion:Evidence-based care can effectively prevent from the occur-rence of CVC-associated adverse reactions and reduce the rate of unplanned extubation in ICU patients, and consequently is worthy of clinical application.