钝性分离法在PICC置管术中的应用

Application of blunt separation in catheterization of peripherally inserted central catheter

目的探讨钝性分离法在经外周静脉穿刺置入中心静脉导管(PICC)的鞘管置入中的应用效果。方法将100例经肘上B超引导下微插管鞘技术置入PICC导管患者按照置管顺序分为观察组和对照组,各50例。观察组在送入血管鞘时采用钝性分离的方法,对照组采用传统的解剖刀沿导丝扩皮后沿导丝送入血管鞘。观察2组PICC渗血、渗液情况以及一次性送鞘成功率。结果观察组患者PICC穿刺处渗血程度较对照组患者轻(P<0.01),观察组发生PICC渗液患者比例低于对照组(P<0.05),2组一次性送鞘成功率比较差异无统计学意义(P>0.05)。结论在PICC置管的鞘管置入中应用钝性分离法可降低血管和皮肤损伤,有效避免渗血和渗液的发生。

Objective To investigate the effect of blunt separation in catheterization of peripherally inserted central catheter（PICC）. Methods Totally 100 patients undergoing b-ultrasound guided PICC modified Seldinger technique were assigned to the observation group and the control group,with 50 cases in each group. In the control group,the PICC catheter sheath was inserted by normal approach. In the observation group,the PICC catheter sheath was inserted by blunt separation approach. The errhysis and drug leakage at puncture site,as well as one-time successful rate of catheterization were compared between two groups. Results Patients in the control group had more severity of errhysis at puncture site compared with those in the observation group（P〈0.01）. The incidence of drug leakage at puncture site was lower in the observation group than that of controls（P〈0.05）. There was no significant difference in one-time successful rate of catheterization between two groups（P〈0.05）. Conclusion Blunt separation is an safe way protecting blood vessel in PICC catheterization. It can also reduce the risk of errhysis and drug leakage at puncture site.