超声检查在经外周静脉穿刺中心静脉置管中的应用

Application of ultrasound examination in peripherally inserted central catheter

目的分析超声在经外周静脉置入中心静脉导管(PICC)置管术中应用价值。方法 310例有PICC置管适应证的患者,分为超声组122例和对照组188例;超声组采用超声引导下的穿刺法进行P1CC置管,并定期超声检测血栓并发症;对照组采用盲插的方法进行PICC置管,仅当出现症状时,进行超声检查。结果超声组中,一次穿刺成功118例(96.72%),总体成功率100%。对照组中,一次穿刺成功132例(70.21%),总体成功率94.68%。超声组的穿刺时间为2.7±1.2 min,明显短于对照组的4.8±1.7 min(P<0.05)。血栓导致拔管超声组0例,对照组5例。结论超声检查提高了PICC穿刺置管成功率,缩短穿刺时间,并可早期发现血栓,便于早治疗,延长导管留置时间。

Objective To explore the application value of ultrasound in peripherally inserted central venous catheter （ PICC ）. Methods 310 patients with PICC catheterization indications were divided into ultrasound group and control group. The patients of ul- trasound group were punctured under the guidance of ultrasound and regularly detected of thrombotic complications by ultrasound. The patients of control group were punctured without ultrasound guidance and not detected by ultrasound until there were the symptoms caused by thrombosis. Results In the ultrasound group, there were 118 eases（96. 72% ） that were punctured successfully one time, and the total successful rate was 100%. In the control group, there were 132 cases （70.21%） that were punctured successfully one time, and the total successful rate was 94. 68%. The time of puncture was 2.7 ± 1.2 min, and it was significant shorter than the other group. There was not a pipe extracted because of thrombosis in the ultrasound group. But there were five in the control group. Conclu- sions Under the help of ultrasound,the successful rate is higher,the time of puncture is shorter,and the thrombosis is found earlier.