两种PICC置管方法在消化科住院患者中的应用效果比较

Comparison of two kinds of PICC catheterization methods in the hospitalized patients of the department of gastroenterology

目的 比较普通PICC置管与超声引导PICC置管方法在消化科住院患者中的应用情况.方法 106例消化科住院患者行PICC置管,分为普通置管组（n=71）和超声引导组（n=35）,比较两组患者穿刺成功率、舒适度和并发症发生率.结果 普通置管组和超声引导组PICC置管一次穿刺成功率（94.4％比94.3％）和总穿刺成功率（98.6％比100％）差异无统计学意义（x2分别为0.03,0.50;P＞0.05）;PICC超声引导组穿刺并发症（2/35,5.7％）显著低于普通置管组（22/71,31.0％）,差异有统计学意义（x2 =8.548,P ＜0.01）.肿瘤化疗患者超声引导置管方法舒适度明显优于普通置管组,但急、慢性胰腺炎患者两组无明显差异.结论 与普通PICC置管比较,超声引导PICC置管成功率相当,但可显著降低并发症发生率,提高肿瘤患者带管生存的舒适度.

Objective To compare the application of common and ultrasound-guided peripherally inserted central venous catheters （PICC） catheterization methods in the hospitalized patients of the department of gastroenterology.Methods One hundred and six the hospitalized patients of the department of gastroenterology with PICC catheterization were divided into the common group （n =71） and the ultrasound-guided group （n =35）.The success rate of puncture,the degree of comfort and the incidence rate of complication were compared between two groups.Results No differences were found in the success rate of first puncture （94.4% vs 94.3%） and the total success rate of puncture （98.6% vs 100%） between the common group and the ultrasound-guided group （x2 =0.03,0.50,respectively; P 〉 0.05）.The incidence of complication in the ultrasound-guided group （2/35,5.7%） was significantly lower than that of the common group （22/71,31.0%）,and the difference was statistically significant （x2 =8.548,P 〈0.01）.The degree of comfort in the ultrasound-guided group was significantly better than that of the common group in the tumor patients with chemotherapy,and no difference was found between the acute and chronic pancreatitis patients.Conclusions The success rate of ultrasound-guided PICC is higher than that of the common PICC,and the ultrasound-guided PICC can significantly reduce the incidence rate of comphcation,and improve the degree of comfort in tumor patients with PICC.