Ⅲ导联联合心电定位在左侧入路PICC患者中的应用

Application of lead Ⅲ combined with ECG localization in patients with PICC via left approach

目的分析Ⅲ导联联合心电定位在左侧入路经外周静脉穿刺中心静脉置管(peripherally inserted central venous cathe‐terization,PICC)中的应用效果。方法选取2016年9月至2018年6月本院行左侧入路PICC置管的60例患者,随机分为对照组与观察组,各30例。对照组患者PICC置管过程中采用Ⅱ导联联合心电定位,观察组患者PICC置管过程中应用Ⅲ导联联合心电定位,经统计学处理比较两组患者的心电定位成功率。结果观察组患者中出现特征性P波28例(93.3%),未出现特征性P波或P波无改变2例(6.7%),其心电定位成功率明显高于对照组,差异具有统计学意义(P<0.05);观察组心电定位成功患者导管尖端为最佳位置25例(89.3%),置入过深1例(3.6%),置入过浅2例(7.1%)其导管尖端位置明显好于对照组,差异具有统计学意义(P<0.05)。结论在左侧入路PICC患者中应用Ⅲ导联联合心电定位具有良好可行性,能够提高心电定位成功率,并改善导管尖端位置,避免了由于反复调整尖端位置而对患者形成的身心损害,促进其静脉通道应用的安全程度。

Objective To analyze the effect of lead Ⅲ combined with ECG localization in the left side approach of central venous catheterization via peripheral vein puncture.Methods 60 patients with left PICC catheterization via left approach from September 2016 to June 2018 were selected.The patients in the control group were randomly divided into two groups:the control group(n=30)and the observation group(n=30).The patients in the control group were treated with leadⅢcombined with ECG localization,while the patients in the observation group with PICC catheter were treated with the combined electrocardiographic localization of leadⅢduring catheterization.Results There were 28 patients with characteristic P wave in the observation group.There was no characteristic P wave or no change in P wave in 2 cases.The success rate of ECG localization was significantly higher than that of control group.The tip position of the catheter in the observation group was better than that in the control group(P<0.05).The tip position of the catheter in the observation group was better than that in the control group,and the position of the tip of the catheter was better in the observation group than in the control group,and the position of the catheter tip was better in the observation group than in the control group(P<0.05).Conclusion The application of leadⅢcombined with ECG localization in patients with left approach PICC has good feasibility,can improve the success rate of ECG localization and improve the tip of catheter.The position avoids the physical and mental damage caused by repeatedly adjusting the tip position,and promotes the safety degree of vein channel application.