乳腺癌患者患侧置入picc管的方法及护理

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1、乳腺癌患者患侧置入PICC管的方法及护理何江冯鹤媛侯玉清易全芳［摘要］目的探讨乳腺癌患者在患乳腺癌5年后患侧上肢置入PICC管的临床效果。方法对经B超检查血管无畸形、通畅，患侧上肢无肿胀的20例患者实施患侧上肢PICC置管，在置管前、置管中、置管后均给予全程系统化整体护理及维护，密切观察并发症并正确及时处理。结果20例患者均经贵要静脉顺利置管，其中5例经肘上，15例经肘下置入。经胸片显示：导管尖端均进入上腔静脉中下段。其中1例出现机械性静脉炎;1例出现穿刺点渗液，经积极处理症状改善。导管留置时间116〜138d,顺利完成6个疗程化疗。结论正确评价患者患侧上肢血管，置管过程中严格执行无菌技

2、术及操作规程、护患配合协作，术后及时发现并正确处理并发症。乳腺癌患者患侧上肢不再是PICC的禁忌证，可进行PICC置管，为双侧乳腺癌患者提供了安全、可靠、方便的静脉输液通道。［关健词】乳腺癌患侧化疗PICCDOI:10.3760/cma.j.issn.1672-7088.2014.21.13作者单位：637000,四川南充，川北医学院附属医院普外三科［作者简介］何江（1971-）,女，汉，木科，副主任护师，护士长。木文系川北医学院附属医院院内课题（川北医附字院［2013］110号）。TheMethodofPICCCatheterintheUpperDiseasedSideamongBre

3、astCancerPatientsandItsNursingHeJiang,FengHeyuan,HouYuqing,YiQuanfangAbstract:ObjectiveTostudytheclinicaleffectofPICCintheupperdiseasedsideofbreastcancerpatientsafterfiveyearsdiagnosed.MethodsTwentypatientswithnovascularmalformation,noobstructionandnoswellingoftheupperdiseasedsidedetectedbyBultra

4、sonicexaminationwereconductedwithPICCcatheter.Systematicholisticnursingandmaintenancewereappliedatalltheprocessandthecomplicationswerecloselyobservedandproperlyhandledintime.ResultsAllpatientscatheterizedsuccessfullybybasilicavein,5casesthroughupperelbow,theother15casesthroughlowerelbow.TheX-rays

5、howedthatallcathetertipswereinthelowerendofsuperiorvenouscavity.Amongthem1caseappearedmechanicalphlebitis,1caseswiththepuncturepointsolutions,allthecomplicationswereimprovedwithpositivetreatment.Theindwellingtimewas116-138days,andsixcyclesofchemotherapycompleted.ConclusionCorrectevaluationofupper

6、extremityvascular,strictaseptictechniqueintheprocessofcatheter,cooperationbetweennursesandpatients,postoperativecomplicationstimelydiscoveredandcorrectedmadetheupperdiseasedsideofbreastcancerpatientsisnolongeratabooofPICC.PICCcouldprovideasafety,reliableandconvenienttransfusionwayfordoublesidebre

7、astcancerpatients.Keywords:breastcancer;diseasedside;chemotherapy;PICC乳腺癌是我国妇女常见恶性肿瘤之一，近年来有明显上升趋势［1］。手术切除病变乳腺联合化疗是治疗乳腺癌的主要方法，因此乳腺癌根治术后化疗显得尤为重要。而对双侧乳腺癌患者如何选择血管通路顺利完成化疗是摆在临床护士面前的一大难题，近年来经外周中心静脉置管(peripherallyinsertedcent