| 费利燕,杨仁梅,谈帮元,白莎莎,赵艳,方婷婷.血液透析用中心静脉导管创新固定装置临床应用效果研究[J].上海护理,2025,25(5): |
| 血液透析用中心静脉导管创新固定装置临床应用效果研究 |
| Study on the effect of clinical application of innovative fixation device for central venous catheter in hemodialysis |
| 投稿时间：2024-05-15 修订日期：2025-05-10 |
| DOI： |
| 中文关键词: 血液透析 中心静脉导管 医用粘贴剂相关性皮肤损伤 导管固定套 护理 |
| 英文关键词:Hemodialysis Central venous catheter Medical adhesive-related skin injury Catheter fixation sleeve nursing care |
| 基金项目:海军特色医学中心卓优人才项目（编号：21TPQN3203） |
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| 中文摘要: |
| 目的：探讨血液透析用中心静脉导管固定装置的临床应用效果。方法：自行设计一种血液透析用中心静脉导管固定装置（导管固定套）。采用方便抽样法，选取2021年5月～2023年5月在上海某三级综合医院使用中心静脉导管行维持性血液透析的90例患者作为研究对象，运用随机数表法分为观察组（n=45）和对照组（n=45）。观察组予以自行设计的导管固定套固定，对照组予以常规透气胶带采用欧米伽固定法固定。4周后比较2组患者的应用效果，主要指标包含医用粘胶剂相关性皮肤损伤发生率、导管滑脱发生率、导管周围皮肤瘙痒、患者舒适度，次要指标包含固定导管耗时和固定材料成本。结果：主要指标：观察组医用粘胶剂相关性皮肤损伤发生率显著高于对照组（P<0.05），2组均未发生导管滑脱；导管周围皮肤瘙痒得分显著低于对照组（P<0.001），舒适度评分显著高于对照组（P<0.001）。次要指标：股静脉导管固定耗时，2组无统计学差异（P>0.05）；颈静脉导管固定耗时、固定材料成本，观察组显著高于对照组（P<0.001）。结论：导管固定套可有效减少医用粘胶剂相关性皮肤损伤，减少导管周围皮肤瘙痒的发生，增加患者的舒适度，其可重复使用性，远期可减少导管固定的材料成本支出，具有一定的经济效益。 |
| 英文摘要: |
| Objective To evaluate the application effect of innovative fixetion device for central venous catheter in hemodialysis.Methods Using convenient sampling method, 90 patients undergoing maintenance hemodialysis with central venous catheter in a comprehensive tertiary hospital in Shanghai from May 2021 to May 2023 were selected as study subjects, and randomized number table method was used to divide them into observation group (n = 45) and control group (n = 45). The observation group was fixed with self-designed catheter fixation sleeve, and the control group was fixed with conventional breathable tape by Omega fixation. After 4 weeks, the efficacy of the two groups was compared. The main indexes included the incidence of medical adhesive -associated skin injury, the incidence of catheter slipping, pruritus around catheter and patient comfort.Secondary indicators included fixed catheter time and fixed material cost. Results Primary outcome: the incidence of medical adhesive -related skin injury in the observation group was significantly higher than that in the control group (P < 0.05), and no catheter slippage occurred in both groups; the score of pruritus around catheter was significantly lower than that of the control group (P < 0.001), and the comfort score was significantly higher than that of the control group (P < 0.001).Secondary outcome: femoral vein catheter fixation time, 2 groups had no statistical difference (P > 0.05); Jugular vein catheter fixation time and the cost of fixed materials were significantly higher in the observation group than in the control group (P < 0.001).Conclusion Using the catheter fixation sleeve to fix CVC for hemodialysis can effectively reduce the incidence of MARSI ,itching of skin around catheter and increasing patient’s comfort and satisfaction.In addition, the device can be reused, and in the long run, it can reduce the material cost expenditure of catheter fixation, which has certain economic benefits. |
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