2580例疑难重症患者PICC成功置入的实践

The practice of successful insertion of PICC in 2580 cases with severe difficult and complicated cases

目的 :总结疑难重症患者PICC成功置入经验,为临床提供置管技术指导。方法 :2015年1月至2016年6月为2580例疑难重症患者成功置入PICC,采用了建立血管分级标准、盲穿置管技术、超声引导下置管技术、超声初步判断导管位置方法以及设计心电图(EKG)定位专用转换夹等方面的综合改进措施。结果 :2580例患者中,血管重度损伤患者980例(38.0%)中,盲穿置管、超声引导下置管成功率分别为99.1%、99.9%;全身严重水肿患者851例(33.0%)中,盲穿置管、超声引导下置管成功率分别为99.0%、99.7%;皮肤极度松弛的患者439例(17.0%)中,超声引导下置管成功率为99.7%;肢体重度挛缩患者310例(12.0%)中,超声引导下置管成功率为99.7%。结论:通过对PICC置管技术改进使我院疑难患者置管成功率保持较高水平。

Objective： To explore the practice of peripherally inserted central catheter （PICC） in patients with severe diseases. Methods： 2580 patients with severe diseases were performed PICC from January 2015 to June 2016. New vascular grading standards were established. Blind insertion technology, ultrasound guidance technology, ultrasound catheter position preliminary judgment method and electrocardiogram （EKG） positioning special conversion clamp were applied during PICC. Results： For the 980 patients with severe vascular injury （38.0%）, the successful rate of the blind insertiontechnology and the ultrasound guidance technology was 99.1 and 99.9% respectively. For the 851 patients with severe systemic edema （33.0%）, the successful rate of the blind insertiontechnology and ultrasound guidance technology was 99.0% and 99.7% respectively. For the 439 patients with skin laxity （17.0%）, the successful rate of the ultrasound guidance technology was 99.7%. For the 310 patients with severe limb contracture （12.0%）, the successfulrate of the ultrasound guidance technology was 99.7%. Conclusion： The improved PICC technology can enhance the successful rate of catheterization in patients with severe diseases.