早产儿PICC尖端超声定位与胸片定位效果比较

Comparison of PICC tip location by ultrasound and traditional chest X-ray in premature infants

目的探讨经超声定位和胸片定位在早产儿PICC置管定位中的应用效果。方法对116例行PICC的早产儿采用自身对照法,尖端定位先后采用X线胸片与超声2种定位方法,即时观察和记录各项指标。结果超声、胸片定位导管尖端显示率分别为99.14%、100%;上下腔静脉心房入口分别为100%、98.28%,100%、95.69%;尖端到心房入口测距显示成功分别为99.14%、93.97%。2种定位法一致性κ=0.806,Spearman相关系数r_(s)=0.753,均P<0.01;超声测量数据四分位间距为0.482 cm,胸片测量数据为0.642 cm;胸片定位X线暴露145次;超声定位操作时间显著短于胸片定位(P<0.01)。结论对PICC早产儿,超声定位可直视导管尖端,安全,操作方便,是一种准确、稳定的早产儿PICC置管尖端定位方法。

Objective To explore the effect of PICC localization by ultrasound and traditional chest X-ray in preterm infants.Methods A self-control study was conducted on 116 preterm infants.PICC localization was confirmed by ultrasound and radiograph,and indexes were observed and recorded immediately.Results The detection rate of tip position was 99.14% by ultrasound and 100% by X-ray.The rates of PICC tip location at the entrance of the superior and inferior caval veins into the right atrium were 100%,100% by ultrasound and 98.28%,95.69% by X-ray.The success rate of measuring the distance between catheter tip and the entrance of the atrium was 99.14% by ultrasound and 93.97% by X-ray.Consistency of the two evaluation techniques was high,with Kappa=0.806 and Spearman correlation coefficient = 0.753(P<0.01 for both).Interquartile range of ultrasonic measurement data was 0.482 cm,and chest radiograph measurement data was 0.642 cm.The number of X-ray exposure was 145.The operation time of ultrasonic localization was significantly shorter than that of chest radiography localization(P<0.01).Conclusion Ultrasound,a safe and easy to operate technique,directly shows the position of catheter tip,so it is an accurate and stable method for premature infants.