B超引导下改良塞丁格技术及前行胸片定位PICC置管在乳腺癌中的应用及护理

Application and nursing of modified Seldinger technology guided by B-ultrasound and anterior chest radiographed PICC catheterization in breast cancer

目的探讨B超引导下改良塞丁格技术及前行胸片定位PICC置管在乳腺癌中的应用效果,为提升置管成功率,降低并发症的发生提供依据。方法选取我院2017年6月~2018年6月收治的乳腺癌化疗PICC置管的患者80例为本研究对象。随机将其分为观察组和对照组,各40例,观察组采取前行胸片定位法后利用B超引导下改良塞丁格技术PICC置管,对照组采取体表测量法常规PICC置管,两组患者置管前后均实施相同护理干预。观察两组患者的一次置管成功率、置管留置时间以及置管并发症的发生情况。结果观察组一次置管成功率为100%,明显高于对照组的85%(P<0.05);置管留置时间为(122.87±11.25)d,显著长于对照组的(98.25±6.12)d(P<0.05)。在并发症方面,观察组发生率为15%,显著低于对照组的57.5%(P<0.05)。结论乳腺癌PICC置管中采用B超引导下改良塞丁格技术及前行胸片定位PICC置管,置管前后给予患者针对性的相同护理干预,可大大提升置管成功率、延长置管留置时间、减少置管并发症的发生,减轻了患者的痛苦,值得临床推广。

Objective To investigate the application of modified Seldinger technology under the guidance of B-ultrasound and anterior chest radiographed peripherally inserted central catheter(PICC)catheterization in breast cancer,and to provide references for improving the success rate of catheterization and reducing the occurrence of complications.Methods 80 patients with PICC catheterization for breast cancer chemotherapy treated in our hospital from June 2017 to June 2018 were selected as the study subjects.They were randomly divided into the observation group and the control group,with 40 cases in each group.The observation group underwent anterior chest radiograph method and the modified Seldinger technique PICC was placed under the guidance of B-ultrasound.The control group took conventional PICC catheterization combined with body surface measurement.The two groups were given the same nursing intervention before and after catheterization.The success rate of one-time catheter placement,the length of indwelling time,and the occurrence of complications in the two groups were observed.Results The success rate of one-time catheter placement in the observation group was 100%,which was significantly higher than 85%in the control group(P<0.05).The indwelling time was(122.87±11.25)days in the observation group,which was significantly longer than(98.25±6.12)days in the control group(P<0.05).The incidence rate of complications in the observation group was 15%,which was significantly lower than 57.5%in the control group(P<0.05).Conclusions In PICC catheterization of breast cancer,the implementation of modified Seldinger technology guided by B-ultrasound and anterior chest radiographed PICC catheterization and the same nursing intervention before and after catheterization,can greatly improve the success rate of catheterization,prolong the indwelling time,reduce the occurrence of complications,relieve the pain of patients,and is worthy of clinical promotion.