创新“切压法”在PICC置管中的应用

Application of “cutting-press” method in the PICC catheterization

目的探讨在血管超声引导结合改良塞丁格技术行经外周静脉穿刺中心静脉置管(PICC)中创新"切压法"的应用效果。方法选取2013年8月—2016年12月血液科收治的血液肿瘤患者100例,超声引导结合改良塞丁格技术行PICC置管过程中采用创新的"切压法",让助手站在穿刺者对侧近患者头部,沿穿刺侧锁骨上缘走向用掌侧切压,压闭穿刺侧颈静脉及其他上行静脉通路。观察置管成功情况。结果 100例患者均置管成功,置管一次性成功率为98.0%(98/100)。结论 "切压法"缩短了血管超声结合改良塞丁格技术行PICC置管的操作时间,拓宽了其适应范围,尤其适用于体瘦、三凹征明显、耳聋、意识不清或语言交流困难等不能行体位配合穿刺的患者。

Objective To evaluate the'cutting-press'method in ultrasound guidance combined with modified Seldinger technique in the peripherally inserted central catheter( PICC) catheterization.Methods Totally 100 hematologic neoplasms with PICC were included in this study.The'cutting-press'method( pressing by palmaris through upper margin of the clavicle at puncture site) was carried out in the PICC catheterization. The catheterization condition of PICC was observed. Results The one-time successful rate of puncture was 98. 0%( 98/100). Conclusion Application of'cutting-press'method may shorten the catheterization time of PICC and broaden the indication range,especially for those with thin figure,with three depression sign,deafness,unconsciousness or low compliance to puncture position.