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预充式SS-Y阀固定法在经导管动脉灌注化疗患者中的应用

The application of pre-filled SS-Y valve fixation in patients undergoing transcatheter arterial infusion chemotherapy

摘要目的:为改善传统动脉导管固定方法易导致导管堵管、患者舒适度低及护士操作满意度低的问题,采用预充式SS-Y阀固定法进行动脉导管护理。方法:选取2017年4月1日至12月31日在浙江大学医学院附属第二医院放射介入科进行经导管动脉灌注化疗(TAI)治疗的54例消化道恶性肿瘤患者为对照组,采用传统方法进行动脉导管护理;选取2018年1月1日至9月30日进行TAI治疗的72例消化道恶性肿瘤患者为观察组,采用预充式SS-Y阀固定法进行动脉导管护理。对2组患者动脉导管的固定情况、患者舒适度、护士操作满意度进行比较。结果:观察组患者动脉导管移位率、滑脱率、护士操作满意度分别为0、0、97.22%(70/72),对照组分别为13.0%(7/54)、5.6%(3/54)、77.78%(42/54),2组患者动脉导管移位率、护士操作满意度比较差异有统计学意义( χ2=9.882、11.813, P<0.01)。滑脱率比较差异无统计学意义( P>0.05)。观察组患者的5个时间点舒适度评分均优于对照组,差异有统计学意义( Z=-6.462~-3.611, P<0.01)。 结论:采用预充式SS-Y阀固定法固定动脉导管牢固可靠,移位率低,同时增加患者舒适度,提高护士操作满意度,可在临床护理中推广。

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abstractsObjective:To improve the problems of catheter occlusion, low comfort of patients and low satisfaction of nurses, the pre-filled SS-Y valve fixation method was used for catheter nursing.Methods:Traditional method of arterial catheter nursing were performed in 54 patients with malignant tumors of digestive tract treated by transcatheter arterial infusion chemotherapy (TAI) (control group) from April 1 to December 31, 2017 in the Department of Radiation Intervention, the Affiliated Second Hospital of Medical College of Zhejiang University. Pre-filled SS-Y valve fixation method was used for arterial catheter nursing in 72 patients treated with TAI (observation group) from January 1 to September 30, 2018. The fixation, comfort and satisfaction of nurses were compared between the two groups.Results:The rate of arterial catheter displacement, slippage and satisfaction of nurses were 0, 0 and 97.22% (70/72) in observation group, and 13.0% (7/54), 5.6% (3/54), 77.78% (42/54) in control group. Significant statistic differences were found between two groups in rate of arterial catheter displacement and comfort scores (χ 2=9.882, 11.813, P<0.01). There was no significant difference in slippage between the two groups ( P>0.05). The comfort scores of the patients in observation group at 5 time points were better than those in control group, and the difference was statistically significant ( Z=-6.462--3.611, P < 0.01). Conclusions:The method of pre-filled SS-Y valve fixation is reliable with a low displacement rate and a higher satisfaction for both patients and nurses. This method can be popularized in clinical nursing.

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