超声引导下PICC置管切皮大小对穿刺点渗血渗液的影响

Effect of PICC Catheter Cuticle Size Under Ultrasound Guidance on Bleeding and Seepage at the Puncture Point

目的探讨超声引导下人为干预PICC置管切皮大小对PICC置管后穿刺点渗血渗液的影响。方法穿刺材料采用美国BD公司生产的导管型号为4fr的PICC导管及其穿刺套装,选取2017年9月至2018年9月在我院肿瘤科室进行置管的60例患者,按自愿原则分为A组(对照组),B组(试验组),A组切皮时采取切皮刀于穿刺点沿导丝方向从表皮进入上肢切开一个与患者上臂成平行方向的0.4 cm的切口,B组采用相同切皮方式切开一个0.2 cm的切口,观察置管后A组与B组PICC穿刺点的渗血渗液情况。结果 B组PICC置管后穿刺点渗血渗液情况明显低于A组PICC置管后穿刺点渗血渗液情况,差异有统计学意义(P<0.05)。结论超声引导下PICC置管切皮0.2 cm穿刺点渗血渗液率明显低于超声引导下PICC置管切皮0.4 cm穿刺点渗血渗液率。

Objective To investigate the effect of ultrasound-guided manual intervention of PICC catheterization on blood and fluid seepage at the puncture point after PICC catheterization.Methods The PICC catheter with type4fr made by BD company and its puncture kit were used for puncture materials.Sixty patients who underwent catheterization in the oncology department of our hospital from September2017to September2018were selected and divided into group A(control group)and group B(experimental group)on a voluntary basis.In group A,a0.4cm incision parallel to the patient's upper arm was made with a scalpel from the epidermis into the upper limb along the direction of the guide wire at the puncture point,while in group B,a0.2cm incision was made with the same scalpel.The blood and fluid seepage of PICC puncture points in group A and group B after catheterization were observed.Results The blood percolation at the puncture point after PICC catheterization in group B was significantly lower than that at the puncture point after PICC catheterization in group A,and the difference was statistically significant(P<0.05).Conclusion The percolation rate of0.2cm puncture point of PICC catheterization under ultrasound guidance was significantly lower than that of0.4cm puncture point of PICC catheterization under ultrasound guidance.