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[目的]探讨造血干细胞移植病人应用耐高压注射型PICC导管(Power PICC)致穿刺点局部感染的相关原因分析和护理对策。[方法]回顾性分析2015年6月—2016年6月我病区留置Power PICC的造血干细胞移植病人122例出现穿刺点局部感染情况。[结果]122例病人出现疑似导管相关血流感染2例,导管脱出15例,导管堵塞12例,导管漂移1例,静脉炎5例,出现穿刺处局部感染21例。21例局部感染病人中,院外感染高于院内,夏季感染高于其他季节,延期换药高于按时换药。采用地塞米松+庆大霉素或联合藻酸盐及IV3000贴膜治疗Power PICC穿刺点局部感染疗效显著,治疗总有效率为100.00%,且经济方便,易为病人所接受。[结论]采用针对性的护理干预可降低造血干细胞移植病人Power PICC局部感染。
[Objective] To explore the causes and nursing countermeasures of local infection of puncture point in patients with hematopoietic stem cell transplantation by using high-pressure injection PICC catheter (Power PICC). [Methods] A retrospective analysis of 122 cases of hematopoietic stem cell transplantation with Power PICC in my ward from June 2015 to June 2016 showed the local infection at the puncture site. [Results] There were 2 cases of suspected catheter-related bloodstream infection in 122 patients, 15 cases of catheter prolapse, 12 cases of catheter blockage, 1 case of catheter drift and 5 cases of phlebitis. There were 21 cases of local infection in the puncture site. In 21 cases of locally infected patients, the nosocomial infection was higher than that in the hospital, and the infection in summer was higher than the other seasons. The delayed dressing change was higher than the timely dressing change. With dexamethasone + gentamicin or alginate and IV3000 film treatment of Power PICC puncture point local infection significant effect, the total effective rate was 100.00%, and the economy is convenient, easy for patients to accept. [Conclusion] Targeted nursing intervention can reduce the local infection of Power PICC in hematopoietic stem cell transplantation patients.