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1、悬空体位在PICC维护中应用的效果观DOI：10.7504/nk2016010203中图分类号：R587.1文献标识码：A摘要：目的探讨PICC维护时采取低半卧位、上肢外展90度、穿刺点下方彻底悬空体位的可行性。方法纳入2015年1月一2015年10月在台州市某三级甲等医院胸外科住院的肺癌术后联合化疗患者90例。随机分为实验组46例和对照组44例。实验组采取低半卧位，留置PICC导管一侧上肢外展90度且穿刺点下方悬空体位；对照组釆取平卧位，留置PICC导管一侧上肢外展60度，且尽最大可能外旋体位，进行常规维护。评价指标包括穿刺点疼痛程度、留置HCC导管一侧上肢肌肉酸痛
2、程度、舒适度；维护前后，PICC留置一侧肢体经皮血氧饱和度、手心皮肤温度、心率；焦虑自评量表(SAS)o结果两组患者焦虑自评量表(SAS)得分均小于50分；两组患者首次维护时穿刺点疼痛程度、PICC留置一侧肢体经皮血氧饱和度比较无统计学意义(P>0.05);两组患者留置PICC导管一侧上肢肌肉酸痛程度及舒适度比较有统计学意义(χ2分别为90.00,63.44;P<0.05)；对照组维护前后，心率、手心皮肤温度比较有统计学意义(t分别为-9.37,-3.27；P<0.05)；实验组维护前后，心率、手心皮肤温度比较无统计学意义(P>0.05
3、)。维护前组间各项指标比较无统计学意义(P>0.05h维护后组间比较,心率、手心皮肤温度有统计学意义(t分别为9.65,3.28；P<0.05)o结论改进后维护体位，只有穿刺点下方彻底悬空的特点，完全不需要通过肢体外旋来暴露消毒范围，用物简单，可操作性强，患者舒适度高，是一种非常人性化的体位。关键词：PICC；悬空体位；舒适度TheapplicationeffectobservationofsuspendingpositionsduringPICCmaintenanceJIA-Limin*,ZHANG-Peng,WANG-Yingzhi,LIN-Yulia
4、n,FENG-Jing.*DepartmentofCardiothoracicSurgery,TaizhouHospital，Linhai317000，ZhejiangProvince,China[Abstract]:0BJECTIVEToexplorethefeasibilityofPICCmaintenancewithlowsemisupine,upperlimbabduction90degrees,aswellascompletelysuspendingpositionbelowthepuncturepoint.METHODSFrom2015.1to2015.1
5、0,weselected90casesoflungcancerpatientsafterbeingoperatedonintheDepartmentofthoracicsurgeryfromagradeAclass3hospitalinTaizhou.Theywererandomlydividedinto2groupswithanexperimentalgroupof46casesandacontrolgroupof44cases.Intheexperimentalgroup,thelowandsemilyingpositionwastaken,andthe90deg
6、reeabductionoftheupperlimbofthePICCcatheterwasretained,withthepuncturepointcompletelysuspendingposition.Controlgrouptookthesupineposition,andperipherallyacentralcatheter(PICC)wasinserted.Thesideoftheupperextremityextensionof60degreesandthemaximumpossibleexternalrotationpositionforregula
7、rmaintenance.Evaluatingindicatorincluding:Thedegreeofpainofpuncturepoint,thedegreeofmusclepainononesideofthePICCcatheter,andthedegreeofcomfortoftheupperlimb;Beforeandaftermaintenance,PICCinsertionononesideofthebodyoftheskinbloodoxygensaturation,palmskintemperatureandheartrate;S
