改良扩皮方法在B超引导下实施PICC置管的临床效果研究

A clinical research on skin incision method for placement of peripherally inserted central venous catheters using ultrasound guidance

目的探讨改良扩皮方法在B超引导下PICC置管患者中的应用效果。方法选择行PICC置管的患者257例分为3组。穿刺成功后:A组采用横切(20°)扩皮法;B组采用纵切(90°)扩皮法;C组采用纵切(0°)扩皮法。观察并比较3组患者置管后穿刺点出血情况、患者疼痛度、送鞘成功率。结果 C组患者扩皮后即刻、置管后24 h及72 h出血量、疼痛度低于A组和B组(P<0.01);C组一次送鞘成功率高于A组和B组(P<0.01)。结论 B超引导下PICC置管扩皮时采用纵切(0°)扩皮法可有效减少扩皮后出血量,减轻患者疼痛,一次送鞘成功率高。

Objective To discuss the effect of skin incision method for placement of peripherally inserted central venous catheters using ultrasound guidance. Methods Totally,257 patients would be placed PICC catheter were randomly divided into three groups, of which group A used lateral skin incision method （20°） ,group B used longitudinal skin incision method（90°） and group C used longitudinal skin incision method（0°）. Then ,to observe and compare bleeding on catheter puncture point, patients＇ pain degree and the success rate of sending sheath between three groups. Results The patients in group C had lower pain degree than other groups at finishing expanding skin instantly, 24 hours and 72 hours after cathetering （ P 〈 0.01 ）. The patients in group C had higher success rate of one - time sending sheath than that of two others （ P 〈 0.01 ）. Conclusion Longitudinal skin incision method for placement of peripherally inserted cen- tral venous catheters using ultrasound guidance can effectively reduce the bleeding on catheter puncture point, relieve patients＇pain and improve the success rate of one - time sending sheath.