经外周静脉置入中心静脉导管在神经外科危重患者中应用常见并发症的原因、预防及护理 优先出版

1914 West China Medical Journal, Vol.28, No.12 Dec. 2013
华西医学 2013, 28（12）
经外周静脉置入中心静脉导管在
神经外科危重患者中应用常见并发症
的原因、预防及护理
胡静
1
，雷军
1
，王飚
1
，苟永胜
2
【摘要】　目的　探讨分析神经外科危重患者经外周静脉置入中心静脉导管（PICC）的常见并发症发生原因，同
时总结并发症有效预防措施及护理对策。 方法　纳入我院2009 年9 月－2012 年9 月期间住院的神经外科重症患
者，统计并发症率，对其进行原因分析，针对性预防和护理。 结果　本组所选190 例患者置入PICC 管后有75 例发
生不同的并发症，其中置管时并发症17 例，含导管异位8 例，送管困难6 例，穿刺失败3 例，发生率为9%；导管留
置期间并发症58 例，包括穿刺点渗血、渗液16 例，意外拔管12 例，静脉炎10 例，导管部分脱出9 例，导管堵塞7
例，导管相关性感染3 例，导管相关性静脉血栓1 例，发生率为30.5%。根据其发生的不同原因，采取积极的治疗和
护理措施，并发症得以治愈，降低了并发症发生率。 结论　规范护理流程，加强临床培训，熟悉和掌握PICC 并发
症的预防和护理措施，可提高PICC 置管、使用的安全性。
【关键词】　PICC；神经外科重症；并发症；原因；预防；护理
【文献标志码】　B　　　　DOI: 10.7507/1002-0179.20130604

The cause ,prevention and care of common complications of the severe ill in neurosurgical patients with
peripherally inserted central catheter (PICC)　HU Jing1, LEI Jun1, WANG Biao1, GOU Yong-sheng2. 1. Department of
Neurosurgery; 2. Department of Orthopedics; The First People’s Hospital of Shuangliu, Shuangliu, Sichuan 610200, P. R.
China
Corresponding author: Lei jun, E-mail:lj_baby@http://wendang.chazidian.com
【Abstract】 Objective The purpose of this article is to investigate how to reduce common complications of the
critically ill neurosurgical patients with peripherally inserted central catheter (PICC),and analyze the reasons. Finally we
summarizes effective preventive measures and nursing cares for complications. METHODS: Basing on three basic method
of complication rate of statistics, its cause analysis, and targeted prevention and care. RESULTS: There are 75 cases
occurring complications in the group which in all contain 190 cases of patients with PICC: including catheter placement
complications in 17 cases, ectopic catheter in 8 cases, sending pipe difcult in 6 cases, 3 cases of puncture failure occurred
9%, and complications during indwelling catheter 58 cases which include puncture site bleeding, exudates 16 cases, 12
cases of accidental exudation, phlebitis 10 cases, 9 cases of catheter portion prolapsed, catheter blockage 7 cases, catheter-
related infections 3 cases, catheter-related venous thrombosis 1 case, the rate was 30.5%. According to the different causes
of its occurrence, we take positive measures of treatment and care. The complications of the patients with PICC have been
effectively controlled, and its incidence has been observably decreased, ultimately, the patients occurred complications
have been cured. CONCLUSIONS: We can improve security of use and placement of PICC catheter through the method of
specifying care process, strengthening clinical training, and mastering skillfully effective preventive measures and nursing
cares for complications.
【Key words】　PICC; neurosurgical intensive; complications; reasons; prevention; care
临床护理
【作者单位】 四川省双流县第一人民医院（双流，610200）1 神经外科，2 骨外科
【作者简介】 胡静（1974 － ），女，四川双流人，主管护师，护士长，大学专科，E-mail：hujing6157@http://wendang.chazidian.com
【通讯作者】 雷军，E-mail：lj_baby@http://wendang.chazidian.com
【网络出版时间】
【网络出版地址】
10.7507/1002-0179.20130604
2013-12-13 14:05
http://wendang.chazidian.com/kcms/doi/10.7507/1002-0179.20130604.html