心电图定位法在肿瘤患者中心静脉导管头端定位中的应用

The application of EKG location method in the cardiac veins catheter tip location in the tumor patients

目的：探讨心电图（EKG）定位法在中心静脉置管过程中确定送管长度的指导作用及术中定位的准确性。方法选择行中心静脉置管的肿瘤患者32例，置管时采取 EKG 数据，术后行 X 线胸片或胸部透视给予验证，判断 EKG 定位法的敏感度、特异度及一次性置管到位率。结果32例肿瘤患者中30例患者出现特征性 P 波，经 X 线胸片或胸透证实在上腔静脉或与右心房连接处，1例置入右心房，1例无 P 波在锁骨下静脉打折经调管后证实进入上腔静脉。结论EKG 定位法在深静脉置管导管尖端定位应用中具有较高的准确性，临床应用是可行的。

Objective To discuss the electrocardiogram（EKG）positioning method to the guiding role of determining the pipe length and the accuracy of operative localization in central venous catheterization procedure. Methods Chose 32 cases of tumor patients who had center venipunture.Use the catheter taken EKG data when cath-etering,and then given validation using postoperative chest X -ray or fluoroscopy.Judgment the sensitivity,specificity and disposable catheters success rate of the EKG positioning method.Results In the 32 cases of cancer patients, 30 patients had characteristic P waves,when the chest X -ray confirmed the superior vena cava or the junction with the right atrium,one case into the right atrium,when one case of non -P -wave in the subclavian after intravenous discounts tune into the tube after it confirmed the superior vena cava.Conclusion EKG positioning method with high accuracy in the deep venous catheter in the catheter tip positioning applications.The clinical applications are feasible.