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中国医药导刊 ›› 2019, Vol. 21 ›› Issue (9): 533-537.

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带涤纶套中心静脉透析导管发生移位的影响因素及对策分析

郜同心,任建伟,房艳辉,郭苹,叶晓静,王娜,康志敏#,高艳   

  1. 航空总医院肾内科北京,100012,航空总医院肾内科北京,100012,航空总医院肾内科北京,100012,航空总医院肾内科北京,100012,航空总医院肾内科北京,100012,航空总医院肾内科北京,100012,航空总医院肾内科北京,100012,航空总医院
  • 出版日期:2019-09-28 发布日期:2019-09-28
  • 基金资助:

Risk Factors for Cuffed Central Venous Catheter-related Displacements and its Countermeasures

GAO Tongxin,REN Jianwei,FANG Yanhui,GUO Ping,YE Xiaojing,WANG Na,KANG Zhimin and GAO Yan   

  1. Department of Nephrology,Aviation General Hospital,Beijing,100012,Department of Nephrology,Aviation General Hospital,Beijing,100012,Department of Nephrology,Aviation General Hospital,Beijing,100012,Department of Nephrology,Aviation General Hospital,Beijing,100012,Department of Nephrology,Aviation General Hospital,Beijing,100012,Department of Nephrology,Aviation General Hospital,Beijing,100012,Department of Nephrology,Aviation General Hospital,Beijing,100012,Department of Nephrology, Aviation General Hospital
  • Online:2019-09-28 Published:2019-09-28

摘要: 目的:分析带涤纶套中心静脉透析导管发生移位的影响因素及对策。方法: 回顾性分析2013年1月至2018年12月我院收治的200例使用带涤纶套中心静脉导管进行维持性血液透析的患者资料,将可能影响患者发生导管移位的因素进行单因素分析和Logistic回归分析。结果:23例导管移位,感染、低蛋白血症、精神异常、反复置管手术史为发生中心静脉导管移位的独立危险因素。结论:操作前充分评估,操作过程严格遵守无菌原则,对可疑的感染征象应用集束化护理措施,改善营养状态,增强机体免疫力,做好患者的心理维护和居家卫生宣教,可有效防止导管移位。

关键词: 维持性血液透析, 中心静脉导管, 导管移位, 导管护理, 影响因素

Abstract: Objective: To analyze the risk factors for cuffed central venous catheter (CVC)-related displacements and its countermeasures. Methods: We retrospectively analyzed the clinical data of 200 patients with indwelling cuffed central venous catheter in hemodialysis treated from January 2013 to December 2018. The univariate analysis and multivariate Logistic regression analysis were performed for the factors influencing the displacement of CVC.Results: Among 200 patients, 23 cases of catheter displacement were diagnosed. Hypoproteinemia, catheter infection, mental disorders and the history of multiple catheterization operations were the factors of catheter displacement. Conclusion: Pro-operative accessment should be arranged adequately,and aseptic technique should be maintained strictly while operating. For the suspicious sign of infection, the measure of care bundles should be adopted. It′s effective in preventing catheter displacement to improve the nutritional status, enhance organism immunity, maintain the psychological healthy of patients, and do good health missionary work.

Key words: Hemodialysis, Central venous catheter, Catheter displacement, Catheter care, Influencing factor