PICC导管断裂移位心血管腔内行介入取出术的护理干预

Interventional therapy for rupture and migration of PICC lines to cardiovascular cavity: nursing interventions

目的探讨PICC导管断裂移位于心脏及大血管内的有效取出方法及护理措施。方法对5例PICC导管断裂移位到心腔和肺动脉内的患者,行单侧或双侧股静脉穿刺,置入猪尾导管及导丝,先将脱落入心腔或肺动脉内的PICC导管的一端拉入下腔静脉内,再置入鹅颈套圈套取PICC导管,自血管鞘拉出体外。结果5例患者心血管腔内的PICC导管均成功取出,伤口愈合良好,无感染及出血等术后并发症。结论应增强医护人员防范意识,根据病情制定个体化护理方案,第一时间发现断裂PICC导管;介入技术取出心血管腔内断裂PICC导管高效安全。

Objective To study an effective method for removal of PICC lines when catheter tips migrate to the heart or large vessels,and to summarize experience of nursing interventions. Methods Five patients had their PICC lines ruptured and catheter tips migrated into cardiac chamber or pulmonary artery.For removal of the PICCs,interventional therapy was performed： a pigtail catheter and a guided wire were placed via femoral vein,then PICC tip was dragged into the inferior vena cava and removed through vascular sheath with gooseneck snare. Results PICC lines were removed successfully and all wounds healed well.None of the patients deve-loped infection and hemorrhage after the therapy. Conclusion Healthcare personnel should enhance awareness of prevention of PICC migration,provide person-centered nursing interventions,and discover rupture of PICCs as early as possible.Interventional therapy for removal of ruptured PICCs is safe and effective.