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目的探讨肿瘤内科高龄患者经外周静脉穿刺中心静脉置管(PICC)非计划性拔管的原因,并总结相关有效的预防措施。方法 92例行PICC静脉化疗患者,以化疗期间发生非计划性拔管42例为观察组,同期未发生非计划性拔管的患者50例为对照组,对两组患者的临床资料进行分析,并总结发生非计划性拔管的风险原因。结果两组患者一般资料比较差异无统计学意义(P>0.05)。非计划性拔管产生的原因包括导管堵塞11例、肢体肿胀8例,皮肤感染9例、导管脱出4例等。结论 PICC非计划性拔管与高龄患者一般资料无关,主要诱因为导管的维护。患者多合并复杂的基础疾病,治疗时间久,静脉输液风险高,由于行动迟缓及感觉迟钝,对输液并发症反应迟缓,再合并焦虑、恐惧等不良情绪,严重干扰临床有效性,护士应加强PICC导管的维护,以预防非计划性拔管风险的产生。
Objective To investigate the causes of unplanned extubation of peripherally punctured central venous catheter (PICC) in elderly patients with advanced oncology and to summarize the relevant and effective preventive measures. Methods Forty-two patients undergoing PICC chemotherapy were enrolled in this study. Forty-two patients undergoing unplanned extubation during chemotherapy were selected as observation group. Fifty patients without extubation during the same period were selected as control group. Clinical data of two groups were analyzed, And summed up the risk of unplanned extubation. Results There was no significant difference in general data between the two groups (P> 0.05). Causes of unplanned extubation include duct blockage in 11 cases, limb swelling in 8 cases, skin infections in 9 cases, catheter prolapse in 4 cases. Conclusion The unplanned extubation of PICC has nothing to do with the general information of elderly patients, the main reason is the catheter maintenance. Patients with complicated underlying diseases, treatment for a long time, high risk of intravenous infusion, due to slow and slow sensation, slow response to infusion complications, and then combined with anxiety, fear and other negative emotions, seriously interfere with the clinical effectiveness of nurses should strengthen the PICC Catheter maintenance to prevent the risk of unplanned extubation.