PICC导管移位致严重心律失常一例

Severe arrhythmia caused by displacementof PICC:a case report

目的:探讨PICC置入及带管过程中出现的心律失常情况,以便及早采取护理干预措施。方法:针对我科一例白血病患儿在带管过程中因病情变化导致PICC异位,引致心律失常原因分析及处理。结果:腹胀导致心脏上抬,PICC导管进入右心房-右心室触发心律失常,将导管尖端后退至上腔静脉中下段,使心律失常得到及时纠正。结论:PICC是血液肿瘤科最常用的中心静脉置管,但心律失常却是其最严重的并发症,只要护理人员熟悉心律失常的表现及原因,及时采取干预措施,就可以将伤害降至最低程度。

Objective：To study the occurrence of arrhythmia induced by displacement of peripherally-inserted central catheter（PICC）and to discuss early nursing interventions.Methods：The underlying cause and respective intervention measures for arrhythmia caused by the displacement of PICC catheter placed in a child with leukemia were retrospectively analyzed.Results：Arrhythmia in this leukemic patient with PICC was caused by the displacement of PICC into the right ventricle via the right atrium,which was in turn closely linked to marked abdominal distention-associated upward elevation of the diaphragm.With proper adjustment of the tip of PICC,arrhythmia was successfullymanaged which was supported by ECG recording.Conclusions：Nurses taking care of childrenwith PICC should be well aware of the common clinical manifestations,underlying causes,and the proper interventions for PICC-associated arrhythmia.