经床旁彩超引导定位在肿瘤患者经外周静脉穿刺中心静脉置管中的应用效果

Application effect of bedside ultrasound guided positioning in central venous catheterization through peripheral venipuncture in tumor patients

目的探讨经床旁彩超引导定位在肿瘤患者经外周静脉穿刺中心静脉置管(PICC)中的应用效果。方法选取2020年1月至2021年1月九江市第三人民医院收治的行PICC置管治疗的88例肿瘤患者为研究对象,根据住院号奇偶数分为对照组和试验组,每组44例。对照组采用盲穿肘下置管法进行置管,试验组则在经床旁彩超引导下进行定位穿刺置管。比较两组患者的置管耗时、一次性置管成功率、总穿刺置管成功率及并发症发生情况。结果试验组的置管耗时为(63.07±8.63)s,短于对照组的(86.45±10.61)s,差异有统计学意义(P<0.05);试验组的一次性置管成功率为93.18%,高于对照组的77.27%,差异有统计学意义(P<0.05);两组患者的总穿刺置管成功率比较,差异无统计学意义(P>0.05)。试验组的穿刺置管并发症总发生率为6.82%,低于对照组的36.36%,差异有统计学意义(P<0.05)。结论肿瘤患者应用经床旁彩超引导定位下进行PICC置管,能提高定位的准确性,有助于提高一次性置管成功率,缩短置管耗时,减少反复穿刺或置管不当带来的相关穿刺置管并发症,临床应用效果良好。

Objective To investigate the application effect of bedside ultrasound guided positioning in peripheral venipuncture central venous catheterization(PICC)in tumor patients.Methods A total of 88 tumor patients treated with PICC catheterization in the Third People′s Hospital of Jiujiang from January 2020 to January 2021 were selected as the research objects,and they were divided into control group and experimental group according to the odd or even number of hospitalization,with 44 patients in each group.The control group was treated with blind puncture under elbow,while the experimental group was treated with positioning puncture under the guidance of bedside color Doppler ultrasound.The time of catheterization,success rate of one-time catheterization,success rate of total puncture catheterization and incidence of complications were compared between the two groups.Results The catheterization time of the experimental group was(63.07±8.63)s,shorter than that of the control group(86.45±10.61)s,and the difference was statistically significant(P<0.05).The success rate of one-time catheterization in the experimental group was 93.18%,higher than that in the control group(77.27%),and the difference was statistically significant(P<0.05).There was no significant difference in the total success rate of puncture catheterization between the two groups(P>0.05).The total incidence of catheterization complications in the experimental group was 6.82%,lower than 36.36%in the control group,and the difference was statistically significant(P<0.05).Conclusion PICC catheterization guided by bedside color Doppler ultrasound can improve the accuracy of positioning,improve the success rate of one-time catheterization,shorten the time of catheterization,and reduce the related complications caused by repeated puncture or improper catheterization.