成年患者PICC导管插入长度与尖端位置的研究

Relationship on Height and Inserted Length of Peripherally Inserted Central Catheter in Adult Patients

目的评估成年患者经外周置入中心静脉导管(peripherally inserted central catheter,PICC)的最佳长度和身高的相关性以及PICC尖端位置异常的发生率。方法回顾性分析2008-2011年200例20岁以上行PICC置管的患者,按照身高分为3组:A组150～160cm;B组161～170cm;C组171～180cm。根据后前位X线胸片比较3组患者左右臂PICC导管的插入长度及尖端位置。结果 3组间左、右两侧PICC置管长度差异均有统计学意义(P<0.01),各组内左、右两侧的插入长度差异也有统计学意义(P<0.05)。3组患者导管最佳位置的比例差异无统计学意义(P>0.05),左右臂导管最佳位置及位点异常的比例差异无统计学意义(P>0.05),但右臂导管走行异常的发生率高于左臂(P<0.05)。结论在PICC置管时,应根据患者身高及左右侧选择适宜的置管长度,当选择右臂置管时应注意防止导管走行异位。

Objective To evaluate the relationship between the optimal length of peripherally inserted cen-tral catheter（PICC） fixation,and the height of adult patients and the incidence of mal-position. Methods Totally 200 patients aged above 20 years undergoing PICC were divided into three groups according to height.group A（150-160 cm）,group B（161-170 cm） and group C （171-180 cm）. The optimal length of PICC fixation and the location of the catheter tip were compared by anteroposterior （AP） chest radio-graph. Results The PICC catheter lengths on the left and right arms were significantly differed among the three groups（P〈0.01）. Significant differences were also observed in PICC catheter lengths on the left and right arms within each group（P〈0.05）. The ratio of optimal tip positions of PICC among the three groups had no significant difference （P〉0.05）. There was no significant difference in the ratio of optimal tip posi-tions and mal-positions on the left and right arms in the same group （P〉0.05）. The incidence of real-posi- tioning was significantly higher in right-side catheters than that in left-side catheters（P〈0.05）. Conclusion The length of the optimal position is related to the height of the patients with PICC. Measures should be taken to prevent PICC mal-position when the intubation of PICC is carried out on the right arm.