B超在预防经外周静脉置入的中心静脉导管术中导管头端异位的应用效果

Application Effect of B-ultrasound in Preventing PICC Catheter Dystopy

目的探讨B超在预防经外周静脉置入的中心静脉导管术(peripherally inserted central cathters,PICC)中导管头端异位的应用效果,以期提高置管成功率。方法便利抽样法选取2013年4月1日至2013年9月31日在第二军医大学长海医院静脉输液门诊进行PICC的患者488例为研究对象,按就诊时间先后分为对照组(n=237)和观察组(n=251)。对照组患者置管时采用转头曲颈法,观察组患者置管时采用B超探头横切按压颈内静脉加以探测定位,比较两组患者置管后发生PICC头端异位的情况。结果对照组237例中5例患者置管后X线摄片示导管尖端异位入颈内静脉;观察组251例中2例患者穿刺置管中发现异位入颈内静脉,立即调整后X线摄片示置管成功。结论 B超不仅有助于提高穿刺成功率,对PICC置管过程中防止导管头端异位入颈内静脉有着较好的定位作用。

Objective To discuss the effect of b-ultrasound in preventing PICC catheter dystopy,in order to improve the success rate of PICC.Methods By convenience sampling,488 cases were divided into control group （n=237） and observation group （n =251）.The patients in control group were applied with conven- tional method,while the observation group were applied with the B-ultrasound probe crosscutting pressing the internal jugular vein to locate the PICC.The incidence of catheter dystopy was compared between two groups.Results Among 237 patients in control group, 5 patients＇ PICC were ectopic into the internal jug- ular vein confirmed by X-ray after process. Among 251 patients in the observation group,2 patients had the same problem in processing, and the PICC were immediately adjusted to the right position.Conclusion B- ultrasound tech could help not only improve the success rate of PICC,but also prevent PICC catheter dys- topy into the internal jugular vein.