危重患者经外周静脉置入中心静脉导管的临床研究——前瞻性随机对照研究

Peripherally inserted central catheter in severely ill patients: A prospective,randomized,controlled study

目的比较经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)与经锁骨下静脉中心静脉置管在危重患者中的临床应用。方法通过前瞻性随机对照研究方法,将80例ICU危重患者分为PICC组(40例)和锁骨下静脉组(40例),观察两组穿刺成功率、穿刺时间、穿刺不良反应发生率等。结果PICC组较锁骨下静脉组一次穿刺成功率高(92.5%vs 75.0%,χ2=4.501,P=0.034),穿刺时间短[(15.7±5.3)min vs(23.9±6.3)min,t=-6.263,P=0.000],总不良反应发生率低(10.0%vs 27.5%,χ2=4.021,P=0.045)。结论PICC穿刺简便易行,危险性小,在危重患者中PICC置管优于锁骨下静脉置管。

Objective To compare the clinical application between peripherally inserted central catheterization(PICC) and subclavian central venous catheterization in severely ill patients.Methods A prospective study was carried out in 80 severely ill patients who had been randomly divided into two groups: receiving either PICC(PICC Group,40 patients) or subclavian central venous catheterization(Subclavian Group,40 patients).The success rate,the puncturing time,and the incidence of adverse reactions in the two groups were observed.Results The rate of successful puncture on one session was higher in the PICC Group(92.5%) than in the Subclavian Group(75.0%)(χ2=4.501,P=0.034).And as compared with the Subclavian Group,the PICC Group reported a shorter puncturing time(15.7±5.3 min vs 23.9±6.3 min;t=-6.263,P=0.000) and a lower rate of adverse reactions(10.0% vs 27.5%;χ2=4.021,P=0.045).Conclusions Use of peripherally inserted central catheterization is simple and safe to perform,superior to subclavian central venous catheterization.