血管超声引导联合微插管鞘技术行PICC置管的环节质量控制

Link quality control of vascular ultrasonography guided modified seldinger technique in PICC placement

目的探讨血管超声引导联合微插管鞘技术行肘上PICC置管时重要环节的质量控制方法。方法 60例患者随机分为治疗组和对照组,各30例。对照组:采用传统穿刺置管方法;治疗组:使用探头与血管呈横切面显像,将靶血管固定在超声屏幕上,左手保持探头始终垂直于皮肤,右手握住穿刺针的针栓处,针尖斜面向上,从探头中心点的外缘与皮肤大约呈45°,先刺入皮肤,再根据针尖与靶血管的位置适当调整进针方向,尽可能从正上方刺入靶血管。结果治疗组穿刺成功率为100%,对照组穿刺成功率为93.3%,差异有统计学意义(P<0.05)。结论血管超声引导联合微插管鞘技术行PICC置管过程中,控制穿刺角度、扩皮和送管方法、置管长度等重要环节,直接影响穿刺成功率。行PICC改善了患者的生活质量,经济简便,易于操作,适用于临床广泛开展。

Objective To explore the link quality control method of vascular ultrasonography guided modified seldinger technique in PICC placement. Method There were 60 patients randomly divided into 2 groups. The control group received traditional catheterization, while the experimental group received modified catheterization. Result The catheterized success rate in the experimental group（100.0%） was higher than the control group（93.3%）, with statistical significance（P〈0.05）. Conclusion In the application of MST, we need to take care of the angle and direction of puncture needle, control the expansion of skin and catheter insertion, which directly affect the success rate of puncture. The use of the link quality control method in PICC placement improves quality of life of the patients, which is worthy of clinical use.