優質護理干預對妊娠劇吐患者留置針引發靜脈炎發生幾率以及睡眠質量的影響

蔣曉娟

摘要?目的：觀察優質護理干預對降低妊娠劇吐患者留置針引發靜脈炎發生幾率以及睡眠質量的影響作用。方法：選取2019年2月至2019年10月廈門市婦幼保健院收治的妊娠劇吐患者80例作為研究對象，隨機分為觀察組和對照組，每組40例。對照組采用傳統改善前的護理方式，觀察組采用改善后的護理方式，觀察2組患者留置針引發靜脈炎發生幾率以及睡眠質量的影響。結果：觀察組患者的優質護理干預可有效降低靜脈炎的發生以及其引發的疼痛，觀察組中發生0級、1級疼痛的患者人數顯著高于對照組，發生2級、3級疼痛的患者人數顯著低于對照組，2組比較差異有統計學意義（P<0.05）;觀察組優質護理后靜脈炎發生率為12.5%，顯著低于對照組的82.5%，2組比較差異有統計學意義（P<0.05）。結論：通過調整靜脈點注藥物順序以及改變點滴方式，輔助患者及其家屬進行良好心理建設，點滴后于留置針的肢體外敷馬鈴薯片的優質護理方式可有效降低妊娠劇吐患者因留置針引發的靜脈炎幾率，改善其點滴體驗并有效提升患者睡眠質量，極大有利于患者的身心健康。

關鍵詞?留置針;靜脈炎;優質護理;睡眠質量

Effect of High Quality Nursing Intervention on Incidence of Phlebitis Caused by Indwresting Needle and Sleep Quality in Patients with Hyperemesis Gravidarum

JIANG Xiaojuan1，2

（1 Xiamen Maternal and Child Health Hospital，Xiamen 361000，China; 2 Women′s and Children′s Hospital affiliated to Xiamen University，Xiamen 361000，China）

Abstract?Objective：To observe the effect of quality nursing intervention on reducing the incidence of phlebitis caused by indwelling needle and sleep quality in patients with hyperemesis gravidarum.Methods：A total of 80 patients with hyperemesis gravidarum admitted to Xiamen Maternal and Child Health Hospital from February to October 2019 were selected as study subjects and randomly divided into observation group and control group，with 40 patients in each group.The control group adopted the traditional nursing mode before improvement，while the observation group adopted the nursing mode after improvement.The incidence of phlebitis caused by indwelling needle and the influence of sleep quality were observed in the two groups.Results：Observation group of patients with high-quality nursing intervention can effectively reduce the occurrence of phlebitis and the cause of pain，0，1 in observation group had a significantly higher number of patients with pain，level 2，level 3 pain occurs in the number of patients was significantly lower than the control group，two groups compare the difference was statistically significant（P<0.05）; The incidence of phlebitis after quality nursing in the observation group was 12.5%，significantly lower than 82.5% in the control group，and the difference between the two groups was statistically significant（P<0.05）.Conclusion：By adjusting the intravenous drip medicine order and change the way a bit，good psychological assist patients and their relatives，needle body topical potato chips after intravenous drip of high quality nursing mode can effectively reduce the hyperemesis gravidarum patients with indwelling needle phlebitis caused by chance，to improve the intravenous drip experience and enhance the patients′ sleep quality，greatly beneficial to the patient′s physical and mental health.

3?討論

留置針雖然其套管柔軟、不易穿破血管等優點廣泛應用于臨床，但留置針往往在較長一段時間內留存于患者體內，加上妊娠劇吐患者的靜滴藥物都是高滲溶液，不當使用常常會引發靜脈炎[1]，進而增加患者的痛苦，延長輸液時間[2-3]，影響患者睡眠質量，不僅在身心上影響患者的健康，無形中也增加了護士的工作量和醫療支出[4]。

留置針引發靜脈炎的原因主要包括留置針在使用過程中引發的物理機械損傷、藥物成分因素以及醫護人員的穿刺熟練程度不夠等。由于針對妊娠劇吐患者采用的靜脈輸液藥物多具有濃度高、刺激性大的特點（比如氯化鉀、復方氨基酸、脂肪乳）[3，5-6]除了通過提升醫護人員穿刺熟練程度，我們還可以通過減少不必要的物理機械損傷，優化點滴藥物的輸液順序以及輸液方式將靜脈炎的發病率和疼痛程度盡可能降到最低。

本研究通過對臨床上妊娠劇吐患者采取不同的護理方式證明：規范的留置針操作技術、針對病患良好的心理疏導、兩路輸液方式配合優化的藥物輸液順序以及靜脈注射后采用外敷馬鈴薯切片可以顯著降低靜脈炎的發病率[7]，降低靜脈炎引發的疼痛，從而延長留置針的使用時間，縮短靜脈注射時間，為病患提供了充足的休息時間，顯著改善了妊娠劇吐患者的身心健康，值得臨床推廣。

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