预见性护理在预防肿瘤化疗中深静脉管堵塞中的应用

摘要

Objective To explore whether the predicted nursing can decrease the incidence of deep venous catheter occlusion of the tumor patients with chemotherapy. Methods We calculated the incidence of deep venous catheter occlusion in the patients with chemotherapy who had the routine nursing from August 2008 to February 2010. To explore the risk factors of deep venous catheter occlusion, all of the patients were divided into two groups; occlusion group and no occlusion group. To explore whether the predicted nursing can decrease the incidence of deep venous catheter occlusion comparing to the routine nursing, we performed a new care: the predicted nursing to the patients with chemotherapy from February 2010 to August 2011 according to PLT ＞ 300 x 109. Results A total of 214 patients were recruited from August 2008 to February 2010. Fifty four patients (25.3%) developed deep venous catheter occlusion. The period of deep venous catheterization, platelet parameters PLT and MPV are significantly higher in the occlusion group than that in the no occlusion group (P ＜ 0.05), No significant difference was found in coagulation parameters PT and APTT between the two groups (P ＞ 0.05). According to PLT ＞ 300 x 109, a total of 98 patients were recruited from February 2010 to August 2011. Eight patients (8.2%) developed deep venous catheter occlusion. Compared to the routine nursing group, the incidence of deep venous catheter occlusion is significantly lower in the no occlusion group (P ＜ 0.05). Conclusion The predicted nursing can decrease the incidence of deep venous catheter occlusion of the tumor patients with chemotherapy.%探讨预见性护理是否能降低肿瘤化疗患者深静脉导管堵塞的发生率.方法:通过查找临床资料,统计我院2008年8月至2010年2月肿瘤化疗患者深静脉置管于常规护理下导管堵塞的发生率,并将其分为堵塞组和未堵塞组,结合血常规探讨导管堵塞发生的高危因素,并根据分析结果及其他相关类似的研究结果,依据Plt＞ 300×109标准,选取2010年2月至2011年8月我院肿瘤化疗深静脉置管患者98例行预见性护理干预.结果:2008年8月至2010年2月期间纳入214例患者,常规护理下其中发生导管堵塞54例(25.3％);与未堵塞组相比,堵塞组置管时间(48±12)d,血小板参数Plt[(325.18±45.32)×109/L]、MPV[(10.31±1.16)d]均升高,组间比较差异有统计学意义(P＜0.01);堵塞组凝血参数PT[(13.16±0.48)s]和APTT[(35.84±2.31)s]与未堵塞组比较,差异无统计学意义(P＞0.05);预见性护理组98例,导管堵塞的发生率为8.20％(8/98),显著低于常规护理组(25.30％,54/214),两组比较差异有统计学意义(x2=12.30,P＜0.01).结论:预见性护理可以减少处于高凝状态下肿瘤化疗患者深静脉导管堵塞的发生.