摘要目的：探讨老年患者PICC置管后发生穿刺点渗血的分级循证护理方案。方法依据循证护理 PICO 原则和患者 PICC 渗血情况，分析导致老年患者 PICC 置管后渗血的原因，计算机检索PubMed、Medline、中国知网、维普资讯及万方数据库，收集处理局部渗血护理措施的临床证据。结果最终纳入2篇临床实践指南、2篇Meta分析和19篇RCT。根据最终检索结果，结合患者病情及渗血分级采取对应护理措施，有效地治疗了22例患者的PICC置管后渗血。结论针对老年患者的PICC置管，合理的穿刺技术及维护方法能有效降低穿刺点渗血的发生。

abstractsObjective To investigate hierachical evidence-based nursing plan on the puncture point oozing blood among elderly patients after PICC catheterization. Methods Based on the PICO principles and patient′s PICC oozing blood condition, the reasons were analyzed about elderly patient′s oozing blood after PICC catheterization, and computer was used to retrieve PubMed, Medline, China hownet, VIP information and Wanfang database for collecting clinical evidence of locally oozing blood nursing. Results Eventually, there were 2 clinical practice guidelines, 2 Meta analysis and 19 RCTs included. According to the results of retrieval and combining with patient′s condition and the implementation of targeted nursing measures for oozing blood hierarchic, a total of 22 patients with oozing blood after PICC catherization were treated effectively. Conclusions For elderly patients with PICC catheterization, reasonable puncture technology and maintenance methods can effectively reduce the incidence of the puncture point oozing blood.