DSA辅助超声引导下PICC导管置入的临床研究

Clinical study of DSA PICC catheter placement assisted ultrasound guidance

目的探讨数字减影血管造影机(DSA)辅助超声引导在PICC置管患者中的临床应用价值。方法在DSA室采用超声引导结合改良塞丁格技术进行穿刺成功后,在DSA的Roadmap功能下沿血管鞘注入1:1浓度的非离子型碘对比剂形成血管走行途径,在DSA监视下置入PICC导管至上腔静脉中下1/3处。结果 21例患者中除一例乳癌健侧手臂无名静脉闭塞的患者改股静脉置管外,其余均顺利置管。结论将DSA及超声有效的结合起来应用于PICC导管置入技术中,既提高了穿刺成功率,又可对导管异位进行及时有效的处理,从而使PICC导管置入过程快速、安全,同时减少了相应并发症的发生,值得临床推广应用。

Objective To investigate the clinical application value of digital subtraction angiography（DSA） in patients with PICC catheter placement assisted ultrasound guidance. Methods In DSA room with ultrasound guidance combined with modified seldinger technique of successful puncture, 1：1 concentration of non-ionic iodine contrast agent was injected under DSA roadmap function along the vascular sheath to form the vascular route. PICC catheter was placed in superior vena cava inferior 1/3 under DSA monitoring. Results In 21 patients, except for one case of breast cancer, the patients with no other side of the arm were occluded by the femoral vein. Conclusion The combination of DSA and ultrasound is effective in the treatment of PICC catheter placement. It can improve the success rate of puncture with timely and effective treatment, so that the process of PICC catheter placement is fast and safe, and it can reduce the occurrence of complications.