Abstract:

Objective To understand the status of decreased shoulder joint function and analyze the influencing factors through investigation of shoulder joint movement during catheter indwelling in patients with PICC. Methods From February to May 2018,patients with PICC were investigated with clinical data questionnaire and shoulder joint function rating scale. Results A total of 208 patients with PICC were included. Shoulder joint function score was 98.99±4.68,and shoulder joint function decreased in 18 cases with an incidence of 8.6%. Single factor analysis showed that catheter type,decreased limb movement at the side of catheter placement,no functional exercise,and pain-related complications were associated with the decline of shoulder joint function（P<0.05）. Multiple linear regression analysis showed that major factors of affecting shoulder joint function was functional exercise and pain-related complications. Conclusion Patients with PICC who had reduced shoulder joint function,no functional exercise and occurrence of pain-related complications could lead to the decline of shoulder joint function. Medical and nursing staff should strengthen the evaluation of shoulder joint function in patients with PICC,focus on and screen influencing factors,so as to reduce the decline in shoulder joint function and improve their quality of life.

Key words: Peripherally Inserted Central Catheters, Catheterization, Central Venous, Shoulder Joint Function, Root Cause Analysis

摘要：

目的 通过对PICC置管患者导管留置期间肩关节活动情况进行调查,了解肩关节功能下降的情况并分析相关影响因素。方法 对2018年2月—5月住院的PICC置管患者,采用患者临床资料调查表、肩关节功能评定量表进行肩关节活动情况调查。结果 共纳入208例PICC置管患者,肩关节功能评分为（98.98±4.69）分,发生肩关节功能下降18例,发生率为8.6%。单因素分析结果显示,导管型号、置管侧肢体活动量减少、未进行功能锻炼及出现了与疼痛有关的并发症与肩关节功能下降有关（P<0.05）。多元线性回归分析结果显示,功能锻炼和与疼痛有关的并发症是影响肩关节功能的主要因素。 结论 PICC置管患者存在肩关节功能下降的情况,未进行功能锻炼及与疼痛有关的并发症的发生可导致肩关节功能下降。医护人员应加强对PICC置管患者肩关节功能的评估,重点关注和筛查这些影响因素,减少肩关节功能下降的情况,提升患者的生活质量。

关键词: 经外周置入中心静脉导管, 导管插入术, 中心静脉, 肩关节功能, 影响因素分析