两种经外周中心静脉留置方法在高龄患者中应用的对比研究

The control study of two kinds of PICC indwelling methods in elderly patients

目的比较两种经外周中心静脉(PICC)留置方法在高龄患者中应用的效果差异。方法选择行PICC的高龄患者40例,随机分为超声引导组和盲穿技术组(各20例),比较两组患者一针穿刺成功率、导管尖端到位率、7d内机械性静脉炎发生率、出血情况、导管堵塞情况、置管后舒适度、穿刺时痛苦度及护士对两种置管的满意度等指标的差别。结果超声引导组一针穿刺成功率高于盲穿技术组,7d内机械性静脉炎发生率、导管堵塞情况低于盲穿技术组,差异有统计学意义(P<0.05),两组导管尖端到位率及出血发生率比较,差异无统计学意义(P>0.05)。超声引导组穿刺时患者的疼痛度低于盲穿技术组,置管后患者舒适度高于盲穿技术组,差异有统计学意义(P<0.05)。结论超声引导结合改良塞丁格技术进行上臂PICC能明显提高一针穿刺成功率,减少机械性静脉炎、堵管的发生率,减轻患者痛苦,提高患者置管后的舒适度。

Objective To compare effects of two kinds of PICC indwelling methods in elderly patients. Methods Forty cases received line PICC catheter in elderly patients were randomly divided into two groups, 20 cases of ultrasound-guided group and the blind intubation group. Success rate of a needle aspiration,rate of the catheter tip in place,incidence of mechanical phlebitis within 7 days bleeding,catheter blockage,catheter,patient comfort,puncture the extent of the suffering of patients and nurses of the two catheter satisfaction and other indicators,were compared. Results For ultrasound-guided group,success rate of needle aspiration was higher than that in blind intubation group ;incidence of mechanical phlebitis within 7 days,incidence of catheter blockage were less than those in blind intubation group, the difference was statistically significant（P〈O.05）. The rate of catheter tip in placerate and incidence of bleeding was no significant difference （P〉0.05）between these two groups. The degree of pain in patient＇s were lower in the ultrasound puncture group than in the blind intubation group, and patient comfort after the catheterhigher in the blind intubation group,the difference was statistically significant （P〈0.05）. Conclusions Ultrasound-guided combined with improved Se Dingge technology arm PICC catheter a needle aspiration can significantly improve the success rate,reducing the mechanical phlebitis, the incidence of plugging, to alleviate the suffering of patients and improve comfort catheter in patients.