三种经外周静脉穿刺置入中心静脉导管置管方法临床应用效果的比较

Comparison of the Clinical Application Effect of Three PICC Catheterization Methods

目的探讨三种经外周静脉穿刺置入中心静脉导管(periperally inserted central catheter,PICC)置管方法的临床应用效果。方法便利抽样法选择2014年1月至2016年7月盐城市第一人民医院肿瘤科收治的需要PICC置管的90例患者为研究对象,按入院先后将其分为传统的PICC置管组、改良塞丁格技术的盲穿组、血管超声引导下结合改良塞丁格技术组,每组各30例,分析并比较三组患者一次性置管成功率、置管期间的穿刺点局部渗血、静脉炎、静脉血栓的发生率,置管使用的时间等。结果血管超声引导下的结合改良塞丁格技术的PICC置管的一次性置管成功率、穿刺点局部渗血、静脉炎、静脉血栓的发生率及置管时间等均优于传统的PICC置管组和改良的塞丁格技术盲穿组(均P<0.05)。结论血管超声引导下的结合改良塞丁格技术的PICC置管极大地提高了一次性穿刺的成功率、减少了局部组织损伤和出血等并发症的发生、在预防机械性静脉炎和静脉血栓方面有着显著的效果,缩短了置管使用的时间,有利于提高患者的满意度,是临床上目前值得推广应用的一种PICC置管方法。

Objective To explore the clinical application effects of three different methods of peripherally inserted central catheter （PICC） catheterization.Methods By convenience sampling,90 patients were selected and divided into the traditional PICC group, modified Seldinger group, and vascular ultrasound- guided modified Seldinger technology group, with 30 cases in each group.The one-time success rate, local area bleeding in puncture site, the incidence of phlebitis and venous thrombosis and the indwelling time were compared.Results The one-time success rate, local area bleeding in puncture site, the incidence of phlebitis and venous thrombosis, the indwelling time in vascular ultrasound-guided modified Seldinger technology group were better than that of traditional PICC group and modified Seldinger group （all P〈0.05）.Conclusions Vascular ultrasound-guided modified Seldinger technology for PICC can improve greatly in the one-time successful rate of cathetering, reduce the complications of local tissue injury and errhysis,prevent the mechanical phlebitis and vein thrombosis, shorten the indwelling time of catheter,and greatly improve the patient satisfaction,which is worth for the clinical application.