经外周静脉置入中心静脉导管拔管困难的原因与护理对策

摘要

Objective To explore the reason and nursing countermeasures of the difficult decannulation of peripherally inserted central catheter (PICC).Methods To analze a comprehensively of a rare case of level IV patients with difficult PICC extubation.Results Indwelling catheter for a long time,vasospasm,blood vessels constricting,phlebitis and venous thrombosis,infection and the formation of fibrin shell were the main factors of difficult extubation.Conclusion During the time of PICC catheter indwelling,besides ob-serving and preventing the complication,we should pay more attention to the operation of PICC extuba-tion,maintain and use the PICC catheter correctly to prevent the occurrence of PICC difficult decannulation effectively.%目的：探索经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC )拔管困难的原因与护理对策。方法对1例罕见的Ⅳ级PICC拔管困难患者进行综合分析。结果导管留置时间过长、血管痉挛、血管收缩、静脉炎、静脉血栓形成、感染和纤维蛋白鞘形成是导致拔管困难的主要原因。结论 PICC 导管留置期间,除并发症的观察和预防外,还应重视PICC拔管的操作,正确维护和使用PICC管,能有效防止PICC拔管困难的发生。