旋转式进针对老年外周静脉置入中心静脉导管穿刺血管塌陷一次穿刺成功率的效果

Effect of Rotary Approach on One-time Success Rate of Vascular Collapse in Aged with PICC

目的比较旋转式穿刺方法与常规穿刺方法对老年外周静脉置入中心静脉导管(PICC)患者穿刺时血管塌陷、血管壁临近导致的一次穿刺成功率的影响。方法选取158例老年PICC患者,随机分为观察组 80例和对照组 78例,观察组采用旋转式进针方法穿刺,对照组采用常规方法穿刺,比较2组一次穿刺成功率,血管挛缩失去穿刺部位、局部感染、导管相关性血栓等相关并发症发生情况及对医疗费用的影响。结果观察组一次穿刺成功率(87.5%,70/80)高于对照组(51.2%,40/78)(P<0.05),血管直径变窄失去穿刺部位、导管相关性血栓发生情况及相关医疗费用低于对照组(P<0.05或P<0.01)。结论旋转式进针方法可提高老年PICC患者穿刺时血管塌陷、血管壁临近导致的一次穿刺成功率,降低导管相关性血栓等并发症,减轻患者经济负担。

Objective To compare the effects of rotary puncture method and conventional puncture method on the success rate of one-time puncture,related complications and medical expenses caused by the proximity of the upper and lower walls of blood vessel when vessels collapsed during puncture in elderly patients with PICC.Methods The 158 elderly patients with PICC were divided into the observation group and the control group.Their blood vessels were punctured to no greater extent than the collapse of the upper and lower walls in the first puncture by conventional puncture method.The rotary puncture method was applied in the observation group,the conventional puncture method was applied in the control group.The success rate of one-time puncture,loss of puncture site due to vascular contracture,local infection,catheter-related thrombosis and medical expenses were compared respectively.Results The success rate of one-time puncture was significantly increased in the observation group (P<0.05) compared with the control group.Narrowing of blood vessel diameter,loss of puncture site,catheter-related thrombosis,and related medical expenses are lower than the control group (P<0.05 or P<0.01).Conclusion The rotary approach can improve the success rate of one-time puncture when vessel wall adjacent to vessel collapse during puncture in elderly patients with PICC,reduce complications such as catheter-related thrombosis and their economic burden.