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王丽英,闻萍,陶雍,薛嵋,管振方,李颜霞,毛静玉.PICC上肢置管患者贴膜处张力性损伤的调查分析[J].上海护理,2019,19(1):
PICC上肢置管患者贴膜处张力性损伤的调查分析
Investigation of Dressing-Related Tension Injuries Among Patients With Peripherally Inserted Central Catheters (PICC)
DOI：
中文关键词:  张力性损伤  PICC  医用敷料相关性皮肤损伤
英文关键词:Tension Injuries  PICC  Medical Adhesive-Related Skin Injury  
基金项目:
作者单位E-mail
王丽英 复旦大学附属肿瘤医院 ying09211170007@126.com 
闻萍* 复旦大学附属肿瘤医院 wpazp@163.com 
陶雍 复旦大学附属肿瘤医院  
薛嵋 复旦大学附属肿瘤医院  
管振方 复旦大学附属肿瘤医院  
李颜霞 复旦大学附属肿瘤医院  
毛静玉 复旦大学附属肿瘤医院  
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中文摘要:
      目的 调查并分析PICC贴膜处张力性损伤的发生情况及相关因素,为临床实践提供一定参考。方法 运用方便取样,调查了复旦大学附属肿瘤医院2015年3.1-3.31在PICC门诊进行导管维护的5444患者,研究工具包括一般资料调查表及张力性损伤影响因素问卷。卡方结果 张力性损伤发生例数176例,发生率为3.23%。导管置管部位、贴膜种类、贴膜内是否使用物品及维护护士维护年资对张力性损伤的发生存在显著影响(P＜0.05)。结论 对患者进行有效评估、合理个性化选择维护用品,同时强化张力性损伤意识及加强无张力贴膜技巧培训等可在一定程度降低PICC贴膜处张力性损伤的发生。
英文摘要:
      Purpose: To investigate the incidence of tension injuries in patients with arm PICC and identify factors associated with tension injury. Methods: An investigation was conducted on 5444 adult patients with arm PICC who chose to maintain catheter in Vascular Access Outpatient Department of Shanghai Cancer Center during one month in 2015. The questionnaire, developed by five vascular access nurse specialists, includes two parts: descriptions of the tension injury and potential contributing factors (patient characteristics; catheter-related information; last maintenance information like the qualification of the maintenance nurse, adhesive type, usage of items underneath the dressing such as gauze and StatLock; previous tension injury history). Chi-Square tests were conducted to identify association factors. Results: Among 5444 patients with arm PICC, 176 suffered from tension injury, resulting in 3.23% incidence. Adhesive types (p<0.001), whether using items underneath dressing or not (P<0.001) and the qualification of maintenance nurses (P=0.001) were significantly associated with experiencing a tension injury. Conclusion: The application of low tension adhesive, personalized maintenance by skilled providers, special attention paid to PICCs placed in forearm could be helpful to prevent and reduce tension injury for patients with arm PICC.
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主管单位：上海市卫生健康委员会   主办单位：上海市护理学会  出版：《上海护理》编辑部
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