Investigation And Analysis The Reasons Of Abnormal Catheter Removal For PICC Patients With Malignant Tumor And Nursing Countermeasures

Peripherally Inserted Central Catheter（PICC） is a technology which refers to thecatheter was inserted into the central venous through peripheral venous and will send tothe superior vena cava to supply liquid medicine and nutrition for the body. The catheterindwelling time of up to one year[1]. Malignant tumor patients need morechemotherapy cycles, PICC can not only reduce the pain caused by repeated puncture,but also avoid irritation and injury to the peripheral veins. When the end ofchemotherapy, patients died, the catheter will be removed. But some cases areabnormally pulled because of human factors or complications caused by pipe, we call itabnormal catheter removal: The treatment is not over yet, due to various reasons(including the accident negligence), the catheter can not be continued to use, must beremoved[2].Abnormal catheter removal affects not only the normal treatment, at thesame time, increase the suffering and economic burden of the patients, and even causethe nurse-patient disputes.This study enrolled270cases of malignant tumor patients with PICC tube indepartment two of Oncology of The Second Affiliated Hospital of Dalian MedicalUniversity between January2009and December2012for retrospective study to analyzethe causes of abnormal catheter removal and to probe the methods of reducing oravoiding abnormal catheter removal phenomenon, and ensure the normal treatment,relieve the suffering and economic burden of patients, reduce the occurrence of nursingdisputes. The results show that:1. Among the270patients,41cases had abnormal catheter removal,14cases ofcatheter-related infection (34.15%),9cases of catheter obstruction (21.95%),5cases oflimb swelling (12.20%),4cases of pipe leakage (9.76%),4cases of severe exudation(9.76%),2cases of catheter displacement (4.88%),2cases of skin rash (4.88%),1cases of catheter prolapse(2.44%).2. Factors of catheter-related infection include:no catheter maintenance period,phlebitis, catheter indwelling time, and the puncture site.3. Catheter obstruction related factors include patients with thrombosis, bloodhypercoagulability, the pipe is not timely flushed after the infusion of a highconcentration liquid4. Factors associated with limb swelling include thrombosis, catheter malposition,puncture technique, local blood circulation disorder.5. The causes of the point of puncture drainage associated with patients’ age, tumortype, the damage to the organization or to the lymphatic during the puncture process.6. Causes of pipe leakage is catheter rupture.7. The main factors leading to skin rash is the season, besides, has no cathetermaintenance cycle is also related.8. The reasons of catheter displacement include patients’ poor compliance forhealth education，the influence of puncture site itself, and improper physical activities.9.Factors leading to catheter prolapse include patients’ carelessly strong pulling ofcatheter, nursing staff accidentally avulsed catheter, catheter exposed too much.In this study, every cause of abnormal catheter removal were analyzed, explorethe factors related to the cause, and provide the corresponding nursing countermeasures.