血管超声与改良赛丁格技术结合应用于经外周置入中心静脉导管

Application of ultrasound-guided modified Seldinger technique in peripherally inserted central catheters

目的对上肢无肉眼可视静脉的患者,临床建立静脉通路困难,探讨血管超声与改良赛丁格技术结合应用于经外周置入中心静脉导管(peripherally inserted central catheters,PICC)的置管方法。方法选择183例均为上肢无肉眼可视静脉的患者,且使用传统置管方法、改良赛丁格技术置管法不能置入PICC,采用便携式血管超声与改良塞丁格技术结合应用于PICC。结果 183例患者中180例置管成功,3例失败,成功率达98.36%,无一例导管异位,每例患者置管后连续观察3个导管留置日,均无导管相关性血流感染发生。结论此技术解决了传统置管方法受血管条件限制的局限性,大大提高了PICC置管成功率,减少了并发症。

Objective It′s difficult to establish vascular passages for the patients with invisible upper venous.The aim of this study is to explore the catheterization on patients with invisible upper venous and failure to apply with peripherally inserted central catheters（PICC） or modified Seldinger technique.Methods 183 selected patients,with invisible upper venous and difficult to establish the intravenous access by routine PICC or modified Seldinger technique,underwent the hand-carry ultrasound-guided modified Seldinger catheterization procedure.Results 180 of the total 183 patients have been catheterized by the ultrasound-guided modified Seldinger technique successfully with the achievement ratio of 98.36 percent.3 of the totality were catheterized failed.There had no displacement of catheter tip and no catheter-related infection occurrence in three days after catheterization.Conclusion the ultrasound-guided modified Seldinger technique overcomes the limitation of the routine PICC on the visibility of venous.This technique improves the catheterization achievement ratio and reduces the complications occurrence simultaneously.