腔内心电图联合超声引导经外周静脉置入中心静脉导管技术尖端定位的应用研究

Study on Application of Intracavitary Electrocardiogram Combined with Ultrasound-guided Peripherally Inserted Central Venous Catheter for Tip Positioning

目的:探究腔内心电图联合超声引导经外周静脉置入中心静脉导管(PICC)技术尖端定位的应用。方法:临床研究对象选取2020年10月—2022年10月在九江市第一人民医院PICC门诊接受PICC置管的患者90例,按照随机数字表法将其分为观察组和对照组,每组45例。对照组采取腔内心电图定位下置管,观察组在对照组基础上联合进行超声引导PICC下置管。观察两组穿刺成功率、PICC尖端位置、数字评分法(NRS)评分、患者满意度及不良反应发生情况。结果:观察组一次性置管成功率(88.89%)显著高于对照组(68.89%),且总置管成功率(97.78%)相对于对照组(86.67%)更高(P<0.05);观察组PICC尖端定位到达最佳位置率(95.45%)相对于对照组(76.92%)更高(P<0.05)。观察组NRS评分优于对照组(P<0.05)。观察组总满意度(95.56%)相对于对照组(66.67%)更高(P<0.05)。观察组不良反应总发生率(4.44%)相对于对照组(20.00%)更低(P<0.05)。结论:针对接受PICC置管患者采取腔内心电图联合超声引导定位一方面有利于提高患者置管成功率,提高患者PICC尖端定位到达最佳位置率及降低患者疼痛程度;另一方面提高患者满意度,降低患者不良反应发生率。

Objective:To explore the application of intracavitary electrocardiogram combined with ultrasound-guided peripherally inserted central venous catheter(PICC)tip positioning.Method:The clinical research subjects selected 90 patients who received PICC catheterization at the PICC outpatient department of Jiujiang NO.1 People's Hospital from October 2020 to October 2022,were divided into observation group and control group according to the random number table method,with 45 patients in each group.The control group received catheterization guided by intracavitary electroencephalography,while the observation group received catheterization guided by ultrasound PICC in combination with the control group.The success rate of puncture,PICC tip positioning,numeric rating scale(NRS)score,patient satisfaction and the occurrence of adverse reactions in two groups were observed.Result:The success rate of single catheterization in the observation group(88.89%)was significantly higher than that in the control group(68.89%),and the total catheterization success rate(97.78%)was higher than that of the control group(86.67%)(P<0.05).Rate of PICC tip localization reaching the optimal position in the observation group(95.45%)was higher than that in the control group(76.92%)(P<0.05).The NRS score of the observation group was better than that of the control group(P<0.05).The overall satisfaction rate of the observation group(95.56%)was higher than that of the control group(66.67%)(P<0.05).The total incidence of adverse reactions in the observation group(4.44%)was lower than that in the control group(20.00%)(P<0.05).Conclusion:Adopting a combination of intracavitary electroencephalography and ultrasound-guided localization for patients undergoing PICC catheterization can improve the success rate of catheterization,increase the rate of achieving optimal PICC tip localization,and reduce patient pain;on the other hand,improving patient satisfaction and reducing the incidence of adverse reactions.