两种穿刺工具在PICC置管中应用的效果观察

Application of two different puncture trocar in peripherally inserted central catheterization

目的比较两种穿刺工具在经外周静脉穿刺置入中心静脉导管(PICC)患者中的应用效果。方法将134例肘部血管较细,弹性较差或肘部无可视血管的患者随机分成观察组和对照组,各67例。对照组采用20 G直式套管针穿刺,常规流程进行PICC置管,观察组采用20 G Y型套管针替代进行穿刺,并改进PICC置管流程。观察2组一次穿刺成功率、静脉炎发生率、皮下淤血发生率。结果观察组一次穿刺成功率高于对照组(P<0.05),观察组静脉炎和皮下淤血发生率低于对照组(P<0.05)。结论对于血管条件差的患者使用20 G Y型套管针替代穿刺,并在置管流程上进行改进,使置管成功率显著提高,静脉炎、皮下淤血发生率下降。

Objective To compare the application of two different puncture trocar in peripher-ally inserted central catheterization （PICC）. Methods Totally 134 patients w ith poor vascularstatus were randomly divided into observation group and the control group,w ith 67cagroup. In the observation group,the 20 G Y - type trocar was used during and the PIC flow was modified. In the control group,PICC catheterization was performed with conventional 20 G straight trocar. The one-time success rates o f puncture,incidence o f phlebitisand subcutaneous hemorrhage were compared between two groups. Results The cess rates of puncture was higher in the obser-vation group than that o f controls （ P 〈 0.05）. The incidence of phlebitis and subcutaneous hemorrhage were lower in the observation group than those in the control group （P 〈 0. 05）. Conclusion 20 G Y-type trocar catheterization was superiorto the 20 G straight-type trocar in PICC fo r patients w ith poor vascular status,wprove the success rate o f catheterization,reduce the complications.