脉冲推注生理盐水在超声引导下PICC置管术中的应用

Bolus Injection of Saline under Ultrasound guided in the Application of Peripherally Inserted Central Catheter

目的探讨脉冲推注生理盐水在超声引导下PICC置管中的作用。方法将138例PICC置管患者,随机分为对照组和观察组,各69例。对照组按传统偏头并下颌贴胸骨法。观察组患者无需偏头,术者在送管同时,助手脉冲推注生理盐水。比较两组异位率、穿刺时长及患者舒适度情况。结果对照组异位10例,占14.5%;观察组异位1例,占1.4%,两组比较有显著性差异(P<0.01)。观察组穿刺时长为11.32±0.79min,对照组穿刺时长为14.98±2.04min,两组比较有显著性差异(P<0.01)。观察组舒适度为2.03±0.62分,对照组的舒适度3.63±1.80分,两组比较有显著性差异(P<0.01)。结论采用脉冲推注生理盐水送管可提高穿刺成功率,降低导管异位发生率,缩短穿刺时长,提高患者的舒适度。

Objective To discuss the role of bolus injection of saline under ultrasound guided in the application of PICC. Methods 138 patients with PICC catheters were randomly grouped,69 patients of control group with traditional partial head and jaw sternums method,69 patients of observationgroup with pulse push saline injection. Comparing the catheter misplacement,puncture time and comfort level of groups after operation. Results 10 cases of the control group were ectopic（ 14. 5%）,1 case of observation group was ectopic（ 1. 4%）,and the difference between the two groups was statistically significant（ P〈0.01）. The puncture time of observation group was（ 11. 32 ± 0.79） minutes,the control puncture was（ 14. 98 ± 2. 04） minutes,and the difference was statistically significant（ P〈0.01）. The comfort level of observation group was（ 2. 03 ± 0. 62）,the control group was（ 3. 63 ± 1. 80 mm）,and the difference was statistically significant（ P〈0.01）. Conclusion Bolus injection of saline may improve the success rate of puncture,reduce catheter misplacement,cut down the puncture time,and enhance the comfort level.