不同深静脉置管方法的临床观察及比较

Comparison of the effect in different kinds of deep venous catheterization

目的探讨经外周静脉行中心静脉置管(peripherally inserted central catheters,PICC)、颈内静脉置管和股静脉置管方法的效果。方法 120例需深静脉置管的病人随机分为三组:A组(PICC置管)、B组(颈内静脉置管)、C组(股静脉置管),每组40例。对比各组的操作成功率、操作时间及导管置入通畅程度及并发症。结果三组总穿刺成功率、操作时间、导管置入通畅程度比较,无明显差异(P>0.05);一次穿刺成功率,A组高于B、C组(P<0.05);三组在发生静脉炎、误入动脉及导管脱落方面差异有显著性(P<0.05)。结论三组深静脉置管均为成熟安全的护理操作技术,在临床上各有利弊,可以互补,PICC组优于颈内静脉组和股静脉组。

Objective： To compare the effect of peripherally inserted central catheter（PICC） with internal jugular vein cannulation and thigh venous catheterization by clinical application. Methods： 120 patients were allocated randomly into three groups with 40 in each： Group A（ PICC）, B （internal jugular vein cannulation） and C （ thigh venous catheterization） ~ The success rate of operation, operative time, the unobstructed degree of catheter and complications were compared respectively. Results：There was no obvious difference in the success rate of operation, operative time, the unobstructed degree of catheter or complications between them（ P 〉 0.05 ） ;the success rate of operation at one time in Group A was higher than that of Group B and C （P 〈 0.05 ） ; the didference was significant between them in the complications, such as phlebitis, dislocation into artery as well as catheter scaling （ P 〈 0. 05 ）. Conclusion： PICC , internal jugular vein cannulation and thigh venous catheterization are the mature and safe nursing techniques, but each has its own advantages and disadvantages and can be complementary each other. PICC is preferable to others.