两种体外测量PICC置管长度的方法比较

Two methods for externally measuring the lengths of peripherally inserted central venous catheter

目的比较两种体外测量经外周静脉置入中心静脉导管(peripherally inserted central venous catheter,PICC)置管长度的方法。方法选择2008年6月～2009年10月本院胃肠外科行PICC置管患者100例,随机分为对照组和实验组,每组各50例。对照组采用从穿刺点至右胸锁关节再向下反折至第3肋间的L型测量法,实验组采用从穿刺点至右胸锁关节一字型测量法,在测量数值的基础上加上3cm为总置管长度。置管成功后予胸片定位,比较两组患者PICC置入上腔静脉的成功率。结果实验组PICC置入上腔静脉的成功率高于对照组(P<0.05)。结论 PICC置管采用一字型的测量方法,可以保证导管置入上腔静脉,提高了置管的安全性,值得临床推广应用。

Objective To introduce two methods by which to measure the lenths of peripherally inserted central venous catheter（PICC）.Methods 100 patients undergoing PICC catheterization were equally randomized to experiment group and control group.In the control group the PICC length was measured by an ＂L＂ method,by which the distances from the insertion site to the right sternoclavicular joint and from the right sternoclavicular joint downward to the third rib were measured and added.In the experiment group,a ＂straight＂ measurement was applied in which the total insertion length was worked out by adding 2 to 3 centimeters to the distance between the insertion site and the right sternoclavicular joint.After PICC catheterization,a chest X ray was taken to confirm the position of the PICC.The success rate was compared between the two groups.Result The success rate was significantly higher in the ＂straight＂ measurement group than in the ＂L＂ method（P 0.05）.Conclusions The ＂straigtht＂ measurement of PICC can guarantee the insertion of catheter into the superior vena cava,improving the safety and the rate of successful insertion.It is promising for clinical application and popularizing.