Abstract: Objective　To explore the effect of nursing care based on failure mode and effect analysis (FMEA) in patients with malignant tumors undergoing peripherally inserted central catheter (PICC). Methods　A prospective study was conducted. A total of 102 patients with malignant tumors who received PICC catheter chemotherapy in Zhengzhou Third People's Hospital from February 2019 to February 2022 were divided into two groups according to the random number table method, with 51 cases in each group. The control group [26 males and 25 females, aged (55.72±2.10) years] received routine intervention, while the observation group [28 males and 23 females, aged (55.67±2.13) years] received nursing intervention based on FMEA, continued nursing for 2 months. The complications during catheterization, comfort degrees, qualities of life, and nursing satisfaction in the two groups were compared. t test and χ² test were used. Results　There were no statistically significant differences in the scores of General Comfort Questionnaire (GCQ) and Health Survey Short Form (SF-36) between the two groups before nursing (all P>0.05). The incidence of complications during catheterization in the observation group was 3.92% (2/51), which was lower than 15.69% (8/51) in the control group (χ²=3.991, P=0.046). After nursing, the physiological [(22.59±3.61) points], psychological [(23.69±4.59) points], mental [(19.67±4.27) points], and social and cultural scores [(13.79±3.25) points] of the observation group were higher than those of the control group, with statistically significant differences (t=6.648, 5.254, 3.462, and 4.790; all P<0.001). After nursing, the scores of physical function [(86.39±3.72) points], physiological function [(83.37±3.59) points], physical pain [(85.45±3.70) points], emotional function [(85.70±4.12) points], life vitality [(85.57±3.80) points], social function [(82.22±3.66) points], mental health [(83.40±3.68) points], and overall health [(83.41±3.69) points] of SF-36 in the observation group were higher than those of the control group (t=15.252, 9.320, 9.026, 9.346, 13.559, 7.717, 8.968, and 6.082; all P<0.001). The scores of health education [(82.86±3.28) points], complication prevention [(83.95±3.42) points], operation skills [(82.87±3.38) points], communication style [(82.96±3.73) points], and catheter maintenance effect [(82.89±3.84) points] of nursing satisfaction in the observation group were higher than those in the control group (t=2.928, 3.297, 2.905, 3.303, and 3.157; all P<0.01). Conclusion　Nursing intervention based on FMEA for patients with malignant tumors undergoing PICC chemotherapy can reduce complications such as deep vein thrombosis, improve their comfort degree with catheter, contribute to the improvement of quality of life, and promote the improvement of patients' satisfaction on nursing services.

Key words: Malignant tumors, Failure mode and effect analysis, Peripherally inserted central catheter, Deep venous thrombosis, Comfort

摘要： 目的　探讨在恶性肿瘤患者经外周静脉置入中心静脉导管（PICC）置管中采取基于失效模式与效应分析（FMEA）的护理效果。方法　采取前瞻性研究，将2019年2月至2022年2月于郑州市第三人民医院接受PICC置管化疗的102例恶性肿瘤患者，依照随机数字表法分为两组，每组51例。对照组男26例、女25例，年龄（55.72±2.10）岁，接受常规干预；观察组男28例、女23例，年龄（55.67±2.13）岁，实施基于FMEA的护理干预，持续护理2个月。比较两组置管期间并发症、舒适度、生活质量和护理满意度。采用t检验、χ²检验。结果　两组护理前舒适状况量表（GCQ）、健康调查简表（SF-36）评分比较，差异均无统计学意义（均P>0.05）。观察组置管期间并发症发生率为3.92%（2/51），低于对照组的15.69%（8/51）（χ²=3.991，P=0.046）。观察组护理后GCQ中生理［（22.59±3.61）分］、心理［（23.69±4.59）分］、精神［（19.67±4.27）分］、社会文化评分［（13.79±3.25）分］均高于对照组，差异均有统计学意义（t=6.648、5.254、3.462、4.790，均P<0.001）。观察组护理后SF-36中躯体功能［（86.39±3.72）分］、生理职能［（83.37±3.59）分］、躯体疼痛［（85.45±3.70）分］、情感职能［（85.70±4.12）分］、生命活力［（85.57±3.80）分］、社会功能［（82.22±3.66）分］、心理健康［（83.40±3.68）分］、总体健康评分［（83.41±3.69）分］均高于对照组（t=15.252、9.320、9.026、9.346、13.559、7.717、8.968、6.082，均P<0.001）。观察组护理满意度中健康教育［（82.86±3.28）分］、并发症预防［（83.95±3.42）分］、操作技能［（82.87±3.38）分］、沟通方式［（82.96±3.73）分］、导管维护效果评分［（82.89±3.84）分］均高于对照组（t=2.928、3.297、2.905、3.303、3.157，均P<0.01）。结论　恶性肿瘤PICC置管化疗患者接受基于FMEA的护理干预，能够减少深静脉血栓等并发症，提高患者带管舒适度，有助于生活质量的改善，促进患者对护理服务满意度的提升。

关键词: 恶性肿瘤, 失效模式与效应分析, 经外周静脉置入中心静脉导管, 深静脉血栓, 舒适度