床边胸部X线摄影在经外周静脉置入中心静脉导管置管术中的应用价值

The application value of portable chest X-ray photography in practice of peripherally inserted central catheterization

目的探讨床边胸部X线摄影在经外周静脉置入中心静脉导管(PICC)术中的应用价值。方法采用移动式床边机对200例PICC术后患者进行仰卧胸部前后位X线摄片。摄片结束后根据临床的需要对图像进行后处理,将处理好的图像,传至医学影像归档与通信系统(PACS),在电脑屏上调整窗宽和窗位,以达到明确PICC管头位置的目的,并向临床提供插管情况。结果导管末端位于上腔静脉186例,导管末端显示不清2例,导管进入右心房5例,导管进入颈内静脉2例,导管在锁骨下静脉内2例,导管反折于腋静脉3例。结论床边摄影检查方便,操作快捷,可迅速获得导管图像,随时反馈给临床,及时纠正导管异位,提高置管成功率。

Objective To study the application value of portable chest X‐ray photography in the peripherally inserted central catheterization（PICC） .Methods Using mobile portable machine to take chest X‐ray film in 200 postoperative patients with the peripherally inserted central catheter placement .According to the clinical needs , the images were processed with adjustment of the window level and window width to identify the tip of PICC on Picture Archiving and Communication Systems（PACS）. Results Tips of the catheters are placed in superior vena cava in 186 cases of all patients ,into the right atrium in 5 cases ,into the internal jugular vein in 2 cases ,in the subclavian vein in 2 cases and in axillary vein in 3 cases ,and tips of the catheters are not clear in 2 cases .Conclu‐sion Portable chest X‐ray photography is easy to take .The images can provide useful information quickly and help to adjust the placement of catheter in time and improve the success rate of catheterization.