摘要
目的 分析急诊成人患者迷你中等长度导管置管相关并发症的发生率、临床特点及主要风险因素,为优化急诊患者血管通路管理和护理质量改进提供循证依据。方法 采用回顾性队列研究设计,纳入246例2024年4月—2025年5月在浙江省某三级乙等医院经急诊救治转住院成人患者的迷你中等长度导管使用的临床资料,分析并发症发生率及临床特点。结果 246例患者总体并发症发生率为17.9%(44/246),以导管堵塞(9.3%)和穿刺点出血(4.9%)为主。Logistic回归分析发现,穿刺次数≥2次(OR=14.515,P=0.006)、合并诊断≥4个(OR=16.759,P=0.004)、置管原因多重组合(OR=7.336,P=0.029)及维护频率≥2次/周(OR=34.459,P<0.001)为急诊成人患者迷你中等长度导管置管相关并发症的风险因素。结论 急诊成人患者迷你中等长度导管并发症风险与穿刺操作、疾病复杂性、置管指征及维护频率等因素密切相关。应规范置管前风险评估、加强首次穿刺成功率、建立带管期间动态评估机制、优化导管管理策略,提供个体化护理管理方案,提升急诊静脉治疗安全与质量。
Objective To analyze the incidence,clinical characteristics,and major risk factors of midline catheterrelated complications in emergency adult patients,and to provide evidence-based support for optimizing vascular access management and improving nursing quality in emergency settings.Methods A retrospective cohort study was conducted.The clinical data of 246 adult patients who received midline catheterization in the emergency department and were subsequently hospitalized in a tertiary grade-B hospital in Zhejiang Province between April 2024 and May 2025.The incidence and clinical characteristics of complications were analyzed.Results The overall incidence of catheter-related complications was 17.9%(44/246),with catheter occlusion(9.3%)and puncture site bleeding(4.9%)as the most common ones.Multivariate logistic regression analysis revealed that≥2 puncture attempts(OR=14.515,P=0.006),≥4 coexisting diagnoses(OR=16.759,P=0.004),multiple indications for catheterization(OR=7.336,P=0.029),and catheter maintenance frequency≥2 times/week(OR=34.459,P<0.001)were significant risk factors.Conclusion The risk of midline catheter-related complications in emergency adults is closely associated with puncture attempts,disease complexity,catheterization indications,and maintenance frequency.It is recommended that risk assessment before catheterization should be standardized;the first-attempt success rate should be enhanced;a dynamic monitoring mechanism during catheter dwell time should be established;catheter management strategies should be optimized.Individualized nursing interventions should be implemented to improve the safety and quality of intravenous therapy in emergency care.
作者
管钦铃
厉珂琼
陈红红
徐李香
GUAN Qinling;LI Keqiong;CHEN Honghong;XU Lixiang
出处
《中华护理杂志》
北大核心
2025年第S1期69-74,共6页
Chinese Journal of Nursing
关键词
迷你中等长度导管
并发症
急诊科
风险因素
护理
Midline Catheter
Complication
Emergency Department
Risk Factors
Nursing Care
