80岁以上高龄患者留置PICC导管异位原因分析

Cause analyse of PICC catheter heterotopia in patients over 80 years old

目的分析80岁以上高龄住院患者留置PICC过程中出现导管异位的原因,探讨预防对策。方法采用回顾分析调查方法,对2011年7月至2014年11月肿瘤病房和干部病房住院的110例80岁以上高龄置管患者的导管异位发生情况进行调查。结果完全卧床不能配合操作患者PICC导管异位发生率为33.33%;穿刺侧肢体有深静脉置管史患者异位率为55.56%;B超联合床旁数字化X光机拍片检查导管异位纠正率100.00%,B超+X光片导管异位纠正率37.50%。结论 80岁以上高龄卧床患者留置PICC出现导管异位率高,应加强穿刺前病史和深静脉置管史评估,合理选择静脉,穿刺过程中调整患者体位等,降低患者留置PICC导管异位率。

Objective To investigate the cause of PICC catheter heterotopia in patients over 80 years old, and explore the prevention measures. Methods Retrospective analysis survey was used in 110 patients over 80 years old with PICC who were hospitalized in tumor ward and cadres ward from July 2011 to November 2014. Results The eetopie rate was 33.33% in patients over 80 years old who were lying in bed completely and could not cooperate, the ec- topic rate was 55.56% in patients who had a history of deep vein catheter at puncture side body. Catheter heterotopia eorrect rate was 100.00% using Ultrasound combined bed digital X - ray machine set, while catheter heterotopia correct rate was 37.50% using Ultrasound and X - ray. Conclusion The incidence of PICC catheter heterotopia is high in bedridden patients over 80 - year - old. It is suggested to strengthen the assessment of medical history and history of deep venipunc- ture, choose reasonable vein, adjust position in the process of puncture to decrease the incidence of PICC catheter heterotopia.