640例经外周静脉置入中心静脉导管的回顾

Peripherally Inserted Central Catheter in Clinical Practice

目的分析置管的成功率和置管后的并发症。方法640例有长期输液适应证的患者参加本研究,材料为美国B-D公司生产的一次性PICC(peripherallyinsertedcentralcatheter),导管由柔软的硅胶材料制成,外径为0.8mm(3Fr)、1.2mm(4Fr)、1.6mm(5Fr)。结果640例患者中,穿刺成功率占95%(包括穿刺两次成功者),失败率占4.8%。609例插管成功后临床表现:(1)上臂胀感的患者占12%;(2)重症静脉炎一般在1周左右发生,占2.6%;(3)导管异位占3%,经调整后恢复正常位置;(4)导管堵塞率在20天以上90天以内发生者占21.3%;(5)清洗堵塞导管成功率占33%,失败率占66.9%。结论此方法具有操作简单,便于长期安全保留在血管内的优点,有临床推广的实用价值。

Objective To analyse the success rate of placement and complications of PICC (Peripherally Inserted Central Catheter)in clinical practice.Methods Six hundred and fourty patients requiring long-term intravenous infusion entered the study.The placed PICCs were made of soft silicon rubber with outer diameter of0.8mm(Fr3),1.2mm(Fr4)or1.6mm (Fr5)(Becton Dickenson,UT,USA).Results Of 640cases,the success rate of placement was95%and the failure rate was4.8%.The physical symptom occurred after the placement in the609success ful cases included:(1)upper-arm distention(12%);(2)severe phlebitis occurre d within1week(2.6%);(3)malposition (3%);(4)tube clog occurred from20days to90days after the placement (21.4%);(5)success rate of cleanout for the occluded catheters was33%,failure rate was66.9%.Conclusions PI CC was simple to place and could be kept in place safely for a longtime,so it could be widely used in clinical practice.