B超引导下改良塞丁格技术在PICC置管术中的临床应用

Modified Seldinger technique under ultrasound guidance in PICC catheterization

目的探讨B超引导下改良塞丁格技术在PICC置管中的应用及效果。方法选取200例拟行PICC患者，随机分为观察组和对照组，每组100例。对照组给予传统盲穿置管法，观察组给予B超引导下改良塞丁格技术置管法。比较两组患者置管成功率、穿刺点渗血率、穿刺点疼痛率、舒适度评分、机械性静脉炎发生率。结果观察组和对照组一次置管成功率分别为89．0％（89／100）和75．0％（75／100），组问比较差异具有统计学意义（P〈0．05）。观察组患者穿刺点渗血发生率、穿刺点疼痛发生率及舒适度评分分别为31．0％（31／100）、4．0％（4／100）、（27．9±2．4）分，对照组分别为48．0％（48／100）、12．0％（12／100）、（20．5±3．0）分，组间比较差异具有统计学意义（P〈0．05）。观察组患者机械性静脉炎发生率明显低于对照组（2．0％vs27．0％），组间比较差异具有统计学意义（P〈0．05）。结论采用B超引导下改良塞丁格技术进行PICC置管，可提高置管成功率、减少不良反应、降低机械性静脉炎，值得临床推广应用。

Objective To evaluate the effect of modified Seldinger technique under ultrasound guidance in PICC catheterization. Methods 200 patients undergoing PICC catheterization were randomly divided into a control group and an observation group, 100 cases for each group. The conventional catheter puncture method under naked eyes was used in the control group and modified Seldinger technique under ultrasound guidance in the observation group. The catheterization success rate, the bleeding rate of puncture point, the pain rate of puncture point, the comfort score, and the mechanical phlebitis rate were compared between the two groups. Results The one-time catheterization success rates of the observation group and the control group were 89.0% （89/100） and 75.0% （75/100）, respectively, with a statistical difference （P〈0.05）. The bleeding rate ofpuncture point, the pain rate of puncture point, and the comfort score of the observation group were 31.0% （31/100）, 4.0% （4/100）, and （27.9±2.4）; and those of the control group were 48.0% （48/100）, 12.0% （12/100）, and （20.5±3.0）; with statistical differences （P〈0.05）. The mechanical phlebitis rate of the observation group was significantly lower than that of the control group （2.0% vs. 27.0%）, with a statistical difference was ly significant （P〈0.05）.Conclusions Using modified Seldinger technique under ultrasound guidance in PICC catheterization can improve the success rate of catheterization and reduce adverse reactions and mechanical phlebitis and in worth being clinically generalized.