介入微导丝应用于PICC导管异位复位中的效果

Study of micro-guide wire application in the PICC malposition

目的探讨介入微导丝在经外周静脉置入中心静脉导管（PICC）导管异位复位中的应用。方法选取2007年3月至2011年12月间发生PICC导管异位的94例患者按是否采用微导丝在DSA引导下调整PICC导管异位分为试验组和对照组各37例，试验组通过置入微导丝，在微导丝指引下对异位的PICC导管进行复位。对照组按常规方法，调整患者体位，盲法送管。比较两组患者一次复位成功率，复位操作时间及机械静脉炎发生率。结果试验组一次复位成功率为100％，对照组为83．38％，试验组复位操作时间为4min，对照组为5min，试验组复位后机械性静脉炎发生率为2．7％，对照组为21．62％，两组比较差异有统计学意义（x2值分别为6．529，7．400，Z=-1．989；P〈0．05或P〈0．01）。结论应用介入微导丝调整P1CC导管异位，具有高复位率，能快速复位，可降低机械性静脉炎发生的优势。

Objective To explore the application of the involvement of micro-guide wire in the peripherally inserted central catheter （PICC） ectopic reset. Methods Totals of 74 patients with PICC ectopic were divided into experimental group and control group, and each group included 37 cases. The experimental group reset ectopie PICC through placing micro-guide wire under the guidance of digital subtraction angiography, while control group adjusted patient position and sent catheter according to conventional methods. The success rate of a reset ,the operating time ,the incidence of mechanical phlebitis were observed. Results The success rate of a reset in experimental group and control group were 100% and 83.88% ,respectively. The operation time during reset procedure were 4 rain and 5 min in experimental and control group, respectively. Regarding the incidence of mechanical phlebitis due to reset,2.7% in experimental group and 21.62% in control group, there were statistical differences in three observational indexes （ x2 = 6. 529,7. 400, respectively; Z = - 1. 989 ; P 〈 0.05 or P 〈 0.01 ）. Conehmions The involvement of micro-guide wire in the PICC ectopic adjustment can reduce the incidence of mechanical phlebitis and have a high reduction ratio.