CN104490522A - 一种用于picc的医用敷料 - Google Patents
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Abstract
本发明提供了一种用于PICC的医用敷料,至少包括透明的膜背衬,膜背衬上固定有海绵基质层,海绵基质层为圆形的冻干海绵,海绵基质层的圆心与圆周之间沿径向开设有用于引出并且固定导管的导管固定开口,导管固定开口呈长条状,导管固定开口的开口端位于圆周上,导管固定开口的长度为海绵基质层半径的20%~45%;所述海绵基质层内含杀菌剂,所述杀菌剂为葡萄糖醛酸氯已定或磺胺嘧啶银,杀菌剂的质量浓度为0.1%~10%;该敷料具有吸液、抑菌和止血功能,过敏率低并且抗菌持久。
Description
技术领域
本发明涉及一种医用敷料,具体涉及一种用于外周导入中心静脉置管(PICC)的医用敷料。
背景技术
外周导入中心静脉置管(Peripherally Inserted Central Catheters,PICC)是由外周静脉穿刺插管,其顶端定位于上腔或锁骨下静脉的置管术。由于PICC导管头部位于中心静脉,血流量大,能迅速降低液体渗透压及药物浓度,从而避免了化疗药物对外周血管的破坏和局部组织的刺激及化疗药物外渗引起的化学性静脉炎和组织坏死。同时PICC减少了患者反复穿刺的痛苦,有效的提高了护理质量及工作效率,也避免了许多临床输液隐患,尤其适用于需要反复多次进行化疗的肿瘤患者,与传统深静脉穿刺技术比较,具有操作创伤小,插管快捷,保留时间长等特点。
PICC虽然具有较多的临床优点,但也具有一些并发症,如穿刺点渗血、渗液、感染等。其中尤其较为的危险的并发症为感染,穿刺部位的细菌可以通过穿刺口进入血液循环中,从而导致导管相关性的血流感染,该并发症的病死率高达12-15%。现有的PICC护理使用的是先消毒,然后使用聚氨酯膜透明敷料进行隔离覆盖。该处理方式具有较好的导管固定以及伤口观察等优势,但有以下缺陷:一、对于大量渗液尚缺乏有效的处理方式,因而对于大量导管渗出液的病人需要显著增加护理频次,增加了护理人员的工作负担;二是穿刺口消毒后灭菌的效期有限,2-3天后皮肤定植细菌会持续增长,抗菌的持续效力有限,显著增加了导管相关性的血流感染的发生几率;三是需要借助外物对穿刺口进行压迫止血,止血效果差。
发明内容
本发明的目的在于解决现有技术的不足,并提供一种具有吸液、抑菌和止血功能的用于PICC的医用敷料。
实现本发明目的所采用的技术方案为,一种用于PICC的医用敷料,至少包括透明的膜背衬,膜背衬上固定有海绵基质层,海绵基质层为圆形的冻干海绵,海绵基质层的圆心与圆周之间沿径向开设有用于引出并且固定导管的导管固定开口,导管固定开口呈长条状,导管固定开口的开口端位于圆周上,导管固定开口的长度为海绵基质层半径的20%~45%;所述海绵基质层内含杀菌剂,所述杀菌剂为葡萄糖醛酸氯已定或磺胺嘧啶银,杀菌剂的质量浓度为0.1%~10%。
所述杀菌剂为葡萄糖醛酸氯已定。
所述膜背衬为硅酮软膜。
所述膜背衬为聚氨酯膜。
导管固定开口的宽度为0.05~0.1mm。
所述海绵基质层的厚度为0.6~10mm。
所述海绵基质层通过热溶法粘固于膜背衬一侧表面的中间。
与现有技术相比,本发明的有益效果为:
1、海绵基质层为圆形的冻干海绵,海绵基质层上开设有用于引出并且固定导管的长条状导管固定开口,导管固定开口的长度小于海绵基质层半径,长度为海绵基质层半径的20%~45%,海绵基质层可以对导管进入的皮肤穿刺口有一定的压迫作用,使得敷料不仅能够更好地覆盖穿刺口,还对穿刺口有一定的压迫固定与止血作用;
2、透明膜背衬为硅酮软膜,相较于聚氨酯膜,硅酮软膜的透气性更好,而且生物相容性强,过敏率相较于聚氨酯膜显著降低,由于使用PICC的患者中肿瘤化疗病人较多,免疫力较低,皮肤较敏感,过敏率较高,因而硅酮软膜背衬可以更好的解决病人的过敏问题;
3、杀菌剂为葡萄糖醛酸氯已定,其质量浓度为0.1%~10%,相较于银离子型杀菌剂,葡萄糖醛酸氯已定的抗菌效力更持久,由于导管相关性的血流感染的细菌60%~70%来源于皮肤的定植菌落,普通酒精或者碘酒消毒后,皮肤菌落会在2~3天重新繁殖,从而引发导管相关性的血流感染,葡萄糖醛酸氯已定的杀菌效力可以持续6~7天,从而可以持久抗菌。
4、海绵基质层为壳聚糖的水溶液混合酸性物质和葡萄糖醛酸氯已定,经过模具定型、冷冻和冻干成型制备而成的冻干海绵,具有良好的吸水效果,可有效吸收穿刺口的渗液,防止穿刺口处皮肤受渗液浸泡。
附图说明
图1为本发明提供的用于PICC的医用敷料的结构示意图。
图2为葡萄糖醛酸氯已定在使用过程中的释放曲线。
其中,1-膜背衬,2-海绵基质层,3-导管固定开口。
具体实施方式
下面结合附图和实施例对本发明进行详细具体说明。
本发明提供的用于PICC的医用敷料,其结构如图1所示,包括透明的膜背衬1和固定在膜背衬上的海绵基质层2,海绵基质层为圆形的冻干海绵,海绵基质层的厚度为0.6~10mm,海绵基质层通过热溶法粘固于膜背衬一侧表面的中间,膜背衬优选硅酮软膜,所述海绵基质层的圆心与圆周之间沿径向开设有用于引出并且固定导管的导管固定开口3,导管固定开口呈长条状,导管固定开口的开口端位于圆周上,导管固定开口的长度为海绵基质层半径的20%~45%,宽度为0.05~0.1mm;所述海绵基质层内含杀菌剂,所述杀菌剂为葡萄糖醛酸氯已定,杀菌剂的质量浓度为0.1%~10%。
取海绵基质层直径为2cm的敷料浸入20mL 37℃的生理盐水中,在浸泡2h、6h、1d、2d、3d、7d、14d、21d和28d后取1.5mL生理盐水通过HPLC测定其中葡萄糖醛酸氯已定的含量,并计算敷料中葡萄糖醛酸氯已定的释放比例,葡萄糖醛酸氯已定在使用过程中的释放曲线如图2所示,右图2可得,本发明提供的敷料中的葡萄糖醛酸氯已定在使用后的6小时内的有较高的突释,6小时到7天时间段内释放逐渐平缓,14天葡萄糖醛酸氯已定接近完全释放,本发明提供的敷料可以在粘附在穿刺口的7天内持续释放抗菌药物,持久抗菌,避免穿刺口受细菌感染。
使用本发明提供的敷料隔离覆盖穿刺口,无需借助外物,通过海绵基质层在2分钟内即可完成止血,临床使用中任意选取80例PICC患者作为统计对象,其中使用聚氨酯膜敷料的患者为对照组,使用本发明提供敷料的患者为实验组,实验组与对照组人数均为40人,常规7天换药一次,连续使用半年,观察患者的感染与过敏情况,结果如下表所示:
过敏率 | 感染率 | |
实验组 | 0 | 0 |
对照组 | 10% | 12.5% |
由上表可以看出,本发明提供的PICC医用敷料具有良好的吸液、抑菌功效,并且使用过敏率极低。
Claims (7)
1.一种用于PICC的医用敷料,至少包括透明的膜背衬,其特征在于:膜背衬上固定有海绵基质层,海绵基质层为圆形的冻干海绵,海绵基质层的圆心与圆周之间沿径向开设有用于引出并且固定导管的导管固定开口,导管固定开口呈长条状,导管固定开口的开口端位于圆周上,导管固定开口的长度为海绵基质层半径的20%~45%;所述海绵基质层内含杀菌剂,所述杀菌剂为葡萄糖醛酸氯已定或磺胺嘧啶银,杀菌剂的质量浓度为0.1%~10%。
2.根据权利要求1所述的用于PICC的医用敷料,其特征在于:所述杀菌剂为葡萄糖醛酸氯已定。
3.根据权利要求1所述的用于PICC的医用敷料,其特征在于:所述膜背衬为硅酮软膜。
4.根据权利要求1所述的用于PICC的医用敷料,其特征在于:所述膜背衬为聚氨酯膜。
5.根据权利要求1所述的用于PICC的医用敷料,其特征在于:导管固定开口的宽度为0.05~0.1mm。
6.根据权利要求1所述的用于PICC的医用敷料,其特征在于:所述海绵基质层的厚度为0.6~10mm。
7.根据权利要求1所述的用于PICC的医用敷料,其特征在于:所述海绵基质层通过热溶法粘固于膜背衬一侧表面的中间。
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CN109692075A (zh) * | 2017-10-20 | 2019-04-30 | 马春霞 | 一种透明止血敷料及保护中心静脉导管的方法 |
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