使用彩超结合改良赛丁格技术引导PICC的临床应用

Clinic Application of Ultra sound with Modified Seldinger Technique Guided PICC

目的了解使用彩色多普勒超声仪(彩超)引导做经外周静脉置入中心静脉导管(PICC)的实用性与优越性。方法随机抽取我院2012年1月至2014年1月60例由于各种原因需要进行PICC的患者,分成2组,其中实验组为通过彩超引导评估血管情况,在彩超引导下结合改良赛丁格技术置入PICC,另一组仅使用改良赛丁格技术进行盲穿,两组均跟踪并分析置管期间详细置管信息。结果彩超引导下结合改良赛丁格技术的PICC从一次置管成功率、置管时间、穿刺点不适、导管堵塞、静脉血栓、静脉炎发生率等方向分析均优越于使用盲穿进行改良赛丁格技术置入PICC导管。结论彩超引导结合改良赛丁格技术进行的PICC穿刺极大提高了穿刺成功率,并且可减少局部组织损伤和并发症的发生,尤其是对机械性静脉炎和静脉血栓的预防起着显著的效果,将是临床操作的主流选择。

Objective To investigate the applicability and superiority of inserting the PICC under the color doppler ultra-sonic guidance using Modified Seldinger Technology（MST）. Methods Choose 116 PICC patients during 2012. 1-2014. 1 in our hospital,divided them into two groups,one group evaluating the vein via ultrasonic imaging,and inserting the PICC under the ultrasonic guidance using MST,and the other one just inset with MST. Track and analyze the detailed information by the patients who had cathetered. Results Through the success rate、insert time、have uncomfortable felling at the puncture sites、catheter blockage, vein thrombosis, phlebitis and so on,The first puncture group has obvious superiority than the other one. Conclusion PICC application through MST under ultrasonic guidance should enhance the rate of successful insersion,reducing various tissue damages, specially for the prevention of vein thrombosis and phlebitis,it can be the mainstream choice during our clinical operation.