婴幼儿B超引导下PICC置管术学习曲线分析

Analysis on learning curve of B ultrasound-guided PICC placement in infants

目的分析婴幼儿B超引导下经外周静脉置入中心静脉导管(PICC)学习曲线。方法回顾性分析2010年1月—2016年6月由同一组操作者施行婴幼儿B超引导下PICC置管术115例,依照操作时间顺序分为A、B组,其中B组又细分为6个亚组(I^VI亚组)。比较各组的操作时间、一次穿刺成功率、并发症、置管失败率。结果 A组与B组各亚组的操作时间具有显著差异(P<0.05),B组Ⅱ亚组与Ⅲ~Ⅵ亚组比较均具有统计学意义(P<0.05),从III亚组起差异无统计学意义(P>0.05)。根据操作时间线形图、箱型图和柱状图分析,进行35例操作后,操作时间已能维持在60 min。各组一次穿刺成功率、并发症情况、置管失败率差异无统计学意义(P>0.05)。结论婴幼儿B超引导下PICC置管术需完成约35例操作方能度过学习曲线,操作时间大致能维持在60 min。

Objective To analyze the learning curve of B ultrasound-guided peripherally in-serted central catheter （PICC） placement in infants. Methods The clinical data of 115 cases of B ultrasound-guided PICC placement operated by the same group of operators from January, 2010 to June 2016 were retrospectively analyzed. According to the operation time sequence, 155 cases were divided into two groups, A and B , and the B group was subdivided into 6 subgroups （ I ~ VI Subgroup）. The operation time, the success rate of first puncture, the complication rate and the failure rate were compared between groups. Results There was a significant difference in opera-tion time between group A and group B （ P 〈 0. 05）. The operation time was longer in II sub-group than that in III, IV, V and VI subgroup, respectively （ P 〈 0.05）. There was no significant difference in operation time among III, IV, V and VI subgroup （ P 〉 0. 05）. According to line di-agram and box plot, the operation time was maintained at the level of 60 min after 35 operations. There was no significant difference in one-time success rate of puncture, complication rate and failure rate of PICC placement among different groups （ P 〉 0.05）. Conclusion In B ultrasound- guided PICC placement in infants, it is required to complete the operation of about 35 cases to complete the stage of learning curve. The operation time can be maintained at about 60min.