悬空体位在PICC维护中应用的效果观察.docVIP

精品论文 参考文献 悬空体位在PICC维护中应用的效果观察 DOI：10.7504/nk2016010203 中图分类号：R587.1 文献标识码：A 　　摘要：目的 探讨PICC维护时采取低半卧位、上肢外展90度、穿刺点下方彻底悬空体位的可行性。方法 纳入2015年1月—2O15 年10月在台州市某三级甲等医院胸外科住院的肺癌术后联合化疗患者90例。随机分为实验组 46例和对照组44 例。实验组采取低半卧位，留置PICC 导管一侧上肢外展90度且穿刺点下方悬空体位；对照组采取平卧位，留置PICC 导管一侧上肢外展60度，且尽最大可能外旋体位，进行常规维护。评价指标包括穿刺点疼痛程度、留置PICC 导管一侧上肢肌肉酸痛程度、舒适度；维护前后，PICC留置一侧肢体经皮血氧饱和度、手心皮肤温度、心率；焦虑自评量表（SAS）。结果 两组患者焦虑自评量表（SAS）得分均小于50分；两组患者首次维护时穿刺点疼痛程度、PICC留置一侧肢体经皮血氧饱和度比较无统计学意义(P gt;0.05)；两组患者留置PICC 导管一侧上肢肌肉酸痛程度及舒适度比较有统计学意义(chi;2分别为90.00,63.44;Plt;0.05)；对照组维护前后，心率、手心皮肤温度比较有统计学意义(t分别为-9.37，-3.27；P lt;0.05)；实验组维护前后，心率、手心皮肤温度比较无统计学意义(Pgt;0.05)。维护前组间各项指标比较无统计学意义(Pgt;0.05)；维护后组间比较，心率、手心皮肤温度有统计学意义(t分别为9.65,3.28；P lt;0.05)。结论 改进后维护体位，具有穿刺点下方彻底悬空的特点，完全不需要通过肢体外旋来暴露消毒范围，用物简单，可操作性强，患者舒适度高，是一种非常人性化的体位。 　　关键词：PICC；悬空体位；舒适度 　　The application effectobservation of suspending positions during PICC 　　maintenanceJIA-Limin*,ZHANG-Peng,WANG-Yingzhi,LIN-Yulian,FENG-Jing.*Department ofCardiothoracic Surgery，Taizhou Hospital，Linhai 317000，Zhejiang Province，China 　　[Abstract]:OBJECTIVE To explore the feasibility of PICC maintenance with low semi supine, upper limb abduction 90 degrees, as well as completely suspending position below the puncture point. METHODS From 2015.1 to 2015.10 ,we selected 90 cases of lung cancer patients after being operated on in the Department of thoracic surgery from a grade A class 3 hospital in Taizhou. They were randomly divided into 2 groups with an experimental group of 46 cases and a control group of 44 cases. In the experimental group, the low and semi lying position was taken, and the 90 degree abduction of the upper limb of the PICC catheter was retained,withthe puncture point completely suspending position.Control group took the supine position, and peripherally a central catheter (PICC) was inserted. The side of the upper extremity extension of 60degrees and the maximum possible external rotation position for regular maintenance. Evaluating indicatorincluding:The degree of pain of punctur