肿瘤患者使用改良塞丁格尔技术及B超行PICC置管的临床研究

Clinical study on the use of modified Jose Dingle technique and B ultrasound in the treatment of cancer patients with PICC Catheter

目的:肿瘤患者使用改良塞丁格尔技术及B超行PICC置管的研究。方法:选取我院2014年1月至2016年1月的肿瘤患者150例为研究对象,将其随机分为观察组、对照组,每组75人,观察组采用改良塞丁格尔技术及B超行PICC置管方法,对照组采用传统的穿刺方法(盲穿法)行PICC置管,观察两组患者一次穿刺成功率、肘上/肘下置管率、静脉炎、血栓、感染、周围组织损伤发生率、导管留置时间。结果:观察组一次穿刺成功率为72.00%,对照组为33.33%;观察组置管率肘上为96.00%,对照肘上置管率为20.00%;观察组静脉炎发生率为2.66%,对照组为18.66%;观察组血栓发生率为1.33%,对照组9.33%,观察组感染、周围组织损伤发生率为0.00%,对照组生率为13.33%,周围组织损伤发生率为8.00%;观察组导管留置时间200天以上70.66%,对照组导管留置时间200天以上37.33%。结论:采用改良塞丁格尔技术及B超行PICC置管方法提高了一次穿刺成功率、总成功率、肘上置管率,降低了PICC置管并发症发生率,延长了导管留置时间,患者痛苦小,值得临床推广应用。

Objective：To study the use of modified Jose Dingle technique and the PICC catheterin cancer patients. Methods： 150 cancer patients in our hospital from January 2014 to January 2016 were selected and were randomly divided into observation group and control group, 75 patients for each group. The observation group was treated with modified Jose Dingle technology and B-mode ultrasound for PICC catheter. The control group was treated with traditional venipuncture method（blind method）for PICC catheter. To observe the success rate of one-time puncture, above/below elbow intubation rate, phlebitis, thrombosis, infection, tissue injury incidence and catheter in dwelling time of two groups. Results：The success rate of one-timepuncture in observation group was 72 % and that of control group was 33.33%. The above elbow catheter rate of observation group was 96% and that of control group was 20%. The phlebitis rate of observation groupwas 2.66% and that of control group was 18.66%. The thrombosis rate of observation group was 1.33% and that of control group was 9.33%. The infection and tissue injury inci- dence rate of observation group was 0% ,the infection rate of control groupwas 13.33% and the tissue injury inci- dence rate of control group was 8%. The rate of catheter indwelling time of more than 200 days in observation group was 70.66% and that of control group was 37.33%. Conclusion： The modified Jose Dingle ultrasound technology and PICC catheter can improve the success rate of one-time puncture, the total success rate and the rate of above el- bow intubation,reduce the rate of PICC puncture complications, extend the catheter in dwelling time and the pa- tients are less painful, which is worthy of clinic application.