| 李东海 程芳 朱超逸 丁岩 华克勤 钱海林.超声引导改良外周静脉导入中心静脉置管术临床应用经验[J].,2015,15(2):298-301 |
| 超声引导改良外周静脉导入中心静脉置管术临床应用经验 |
| Clinical Experience of Color Doppler Ultrasound- Guided ImprovedPeripherally Inserted Central Catheter |
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| DOI： |
| 中文关键词: 外周静脉导入中心静脉置管术 超声引 导 穿刺支架 |
| 英文关键词: Peripherally inserted central catheter Color Doppler guidance Puncture frame |
| 基金项目:上海市科学技术委员会西医类引导项目（ 1 241 19a5501） |
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| 中文摘要: |
| 目的： 探讨超声引 导下改良的外周静脉导入中心静脉置管术(Peripherally Inserted Central Catheter， PICC)的临床应用 。 方法：
对 42 例 有恶性肿瘤病史需行 PICC 置管、浅静脉直视下不明 显或触摸不到、不适合盲穿患者 42 例进行超声 引 导下改良的 PICC
术。 改良方法包括穿刺支架超声引 导以及用 一次性使用 麻醉用 针替代 Seldinger 包内 的穿刺针进行，并与 23 例 标准 PICC 法对比
分析穿刺成功率及穿刺并发症发生率。 结果： 两种方法穿刺成功率均为 1 00 %， 其中改良 PICC 患者 41 例穿刺一次成功， 一次成
功率为 97.6 %； 标准 PICC 患者 21 例 穿刺一次成功，一次成功率为 91.3 %。 两种方法一次成功率差异无统计学意义(P>0.05)。 42
例 改良患者中发生 2 例并发症， 包括局部水肿 1 例及导管异位 1 例 ； 23 例标准 PICC 患者中发生 6 例 并发症， 包括局部水肿 2 例，
导管异位 1 例，静脉炎 1 例及局部感染 2 例。 两种方法并发症发生率差异有统计学意义(P=0.019)。 结论： 超声 引 导下改良的 PICC
术一次成功率高， 并发症少，值得临床推广。 |
| 英文摘要: |
| Objective:The aim of this study was to investigate the clinical value and the advantages of the improved peripherally
inserted central catheter (PICC) guided by color Doppler ultrasound.Methods:Forty-two patients with malignant tumor history were
included in this study. They all needed PICC and were not suitable for blind puncture because the superficial veins were not palpated.
The improved PICC guided by color Doppler ultrasound were used. The improvements included the use of puncture frame on the probe
and the substitution of one-off anesthesia needles for puncture needles in Seldinger package. The puncture success rate and the
complication rate were analyzed and compared with 23 patients using standard PICC.Results:Both the improved PICC and the standard
PICC had a 100 % puncture success rate. One-time success rate of the improved PICC and standard PICC were 97.6 % (41 /42) and 91 .3
% (21/23). And the difference was not statistically significant (P>0.05). Two patients with improved PICC had complications, including
one case of local edema and one case of catheter heterotopia; six patients with standard PICC had complications, including two cases of
local edema, one case of catheter heterotopia, one case of phlebitis and two cases of local infection. And the difference of the
complication rate was statistically significant (P=0.019).Conclusion:The improved PICC guided by color Doppler ultrasound had
higher success rate and lower complication rate compared with standard PICC and it was worthy of clinical promotion. |
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