个体化护理在肿瘤PICC置管患者中的应用价值探讨

陈登峰

[摘要] 目的 對个体化护理在肿瘤PICC置管患者中的应用价值进行分析。方法 方便选取2015年2月—2017年2月福建省漳州市中国人民解放军第一七五医院普通外科肿瘤PICC置管患者48例随机分两组。A组采用常规化护理方案，B组采用个体化护理方案。比较两组患者PICC置管护理满意度；肿瘤知识知晓评分、PICC置管知识掌握情况、PICC置管依从性；护理前和护理后患者情绪状态的差异；穿刺点感染、导管堵塞和静脉炎等并发症的发生率。结果 B组患者PICC置管护理满意度95.83%高于A组75%（P<0.05）；B组肿瘤知识知晓评分、PICC置管知识掌握情况、PICC置管依从性（94.18±2.13）分、（95.36±4.13）分、（92.56±8.13）分高于A组（81.71±1.02）分、（82.01±1.21）分和（80.31±7.82）分（P<0.05）；护理前两组情绪状态比较差异无统计学意义（P>0.05）；护理后B组情绪状态改善幅度更大（P<0.05）。B组患者穿刺点感染、导管堵塞和静脉炎等并发症发生率8.33%低于A组50.00%（P<0.05）。结论 个体化护理在肿瘤PICC置管患者中的应用价值高，可有效改善患者不良情绪，提高其对疾病和PICC置管的认知，提高PICC置管依从性，减少PICC置管并发症发生，患者满意，值得借鉴。

[关键词] 个体化护理；肿瘤PICC置管患者；应用价值

[中图分类号] R47 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0150-03

[Abstract] Objective To analyze the application value of individual nursing in patients with tumor PICC catheterization. Methods 48 cases of patients with tumor PICC catheterization admitted and treated in our hospital from February 2015 to February 2017 were convenient selected and randomly divided into two groups， the group A adopted the routine nursing plan， while the group B adopted the individual nursing plan， and the satisfactory degree of PICC catheterization， awareness score of tumor knowledge， mastery situation of PICC catheterization knowledge， compliance of PICC catheterization， difference in the emotion state before and after nursing， puncture point infection， catheter obstruction and incidence rate of phlebitis were compared between the two groups. Results The satisfactory degree of PICC catheterization in the group B was higher than that in the group A（95.83% vs 75%）（P<0.05）， and the tumor knowledge awareness score， mastery of PICC catheterization knowledge and compliance of PICC catheterization in the group B were higher than those in the group A[（94.18±2.13）points（95.36±4.13）points，（92.56±8.13）points vs （81.71±1.02）points，（82.01±1.21）points，（80.31±7.82）points]（P<0.05）， before nursing， there was no obvious difference in the emotion state between the two groups（P>0.05）， after nursing， the improvement range of emotion state in the group B was bigger（P<0.05）， and the incidence rate of puncture point infection， catheter infection and phlebitis in the group B was lower than that in the group A（8.33% vs 50.00%）（P<0.05）. Conclusion The application value of individual nursing in patients with tumor PICC catheterization can effectively improve the bad emotion， improve the cognition of disease and PICC catheterization， improve the compliance of PICC catheterization and reduce the occurrence of PICC catheterization complications and the patients are satisfied， which is worth reference.

[Key words] Individual nursing； Patients with tumor PICC catheterization； Application value

肿瘤是临床常见疾病，可威胁患者生命安全，早期多行手术治疗，而术后进行辅助化疗是多数肿瘤患者有效治疗方法，但传统经外周静脉穿刺输入化疗药物很容易发生静脉炎，出现渗漏性损伤。经外周静脉穿刺置入中心静脉导管（PICC）则可克服传统置管的缺陷，可避免化疗药物长期刺激以及长时间输注引发的局部组织刺激，减轻血管损伤，是便捷、安全的化疗药物静脉通路，确保化疗顺利进行[1-2]。但肿瘤患者PICC置管过程若护理不当可出现导管堵塞等并发症，影响患者依从性和治疗效果，需做好护理工作[1-3]。该研究将2015年2月—2017年2月肿瘤PICC置管患者48例随机分两组，分析了个体化护理在肿瘤PICC置管患者中的应用价值，現报道如下。

1 资料与方法

1.1 一般资料

方便选取该院收治的肿瘤PICC置管患者48例，随机分两组。……