心电导联多普勒超声一体机引导下PICC置管及集束化管理的临床意义分析

Guided by ECG lead Doppler ultrasound all-in-one mach ine Clinical significance of PICC catheter ization and cluster management

目的分析应用集束化管理模式和心电导联多普勒超声一体机(EDGU)引导下PICC置管成功率及相关并发症发生情况,并探讨其临床意义。方法回顾性分析2019年1月-2021年8月在航空总医院采用心电导联多普勒超声一体机(EDUG)引导下PICC置管成功的200例患者置管及集束化护理管理情况。结果200例心电导联多普勒超声一体机(EDUG)引导下PICC置管路径贵要静脉169例(占84.50%)、肱静脉20例(占10.00%)、头静脉11例(占5.50%),一次性置管成功率96.5%。置管中出现的问题有送导丝困难5例(2.50%)、送管困难4例(2.00%)、原发性导管异位4例(2.00%)、心电图尖端定位时P波未显示9例(4.50%)、导管头端进入颈内静脉2例(1.00%),及时调整后成功率100%。术后并发症2例,1例为穿刺周围血肿形成,1例为术后导管周围血栓形成。结论运用心电导联多普勒超声一体机引导下PICC置管及通过集束化管理模式的应用,实现实时引导、全程可见,大大地提升了PICC置管成功率并减少了并发症的发生,充分体现“以人为本”的护理理念,值得临床推广。

Objective To analyze the success rate of PICC catheterization and related complications under the guidance of cluster management mode and ECG lead Doppler ultrasound integrated machine(EDUG),and to explore its clinical significance.Methods The ECG lead Doppler ultrasound integrated machine was used in aviation general hospital from January 2019 to August 2021.Results The success rate of one-time PICC catheterization was 96.5%.The problems in catheterization included 5 cases(2.50%),4 cases(2.00%),4 cases(2.00%)of primary ectopic catheter 9 cases(4.50%)did not show P wave at the tip of ECG,and 2 cases entered the internal jugular vein at the tip of catheter(1.00%),the success rate after timely adjustment was 100%.There were 2 cases of postoperative complications,1 case was hematoma formation around puncture and 1 case was thrombosis around catheter.Conc lus ion PICC catheterization guided by ECG lead Doppler ultrasound and the application of cluster management mode can realize real-time guidance and whole process visibility,which greatly improves the success rate of PICC catheterization and reduces complications.It fully embodies the nursing concept of“people-oriented”,which is worthy of clinical promotion.