改良心电导引定位技术对人类免疫缺陷病毒患者PICC的影响

Effect of modified electrocardiogram guided localization on PICC in HIV patients

目的探讨改良心电导引定位技术对人类免疫缺陷病毒(HIV)患者外周静脉穿刺中心静脉置管术(PICC)的影响。方法前瞻性研究,选取2022年1月至2023年2月常州市第三人民医院收治的需行PICC的HIV患者100例作为研究对象,采用随机数字表法分为两组,各50例。对照组男42例、女8例,年龄(46.60±14.63)岁,予人工手动推注生理盐水;试验组男46例、女4例,年龄(46.24±15.71)岁,予改良心电导引定位技术。对比两组患者置管后导管头端到位率、置管时导管异位率、心电导引定位耗时、并发症发生率及患者满意度。统计学方法采用t检验、χ^(2)检验。结果试验组患者PICC头端准确到位率及患者满意度均高于对照组[98.0%(49/50)比82.0%(41/50)、98.0%(49/50)比80.0%(40/50)],并发症发生率低于对照组[10.0%(5/50)比30.0%(15/50)],心电导引定位耗时短于对照组[(17.56±1.64)s比(33.22±2.75)s],差异均有统计学意义(χ^(2)=7.111、8.274、6.250,t=32.604;均P<0.05)。试验组患者在置管过程中发生导管异位率为2.0%(1/50),与对照组[6.0%(3/50)]比较,差异无统计学意义(χ^(2)=1.042,P=0.307)。结论改良心电导引定位技术在HIV患者中应用安全精准,经济实用,可提高患者满意度,降低置管后并发症发生率。

Objective To investigate the effect of modified electrocardiogram guided localization on peripherally inserted central catheter(PICC)in patients infected with human immunodeficiency virus(HIV).Methods One hundred HIV patients admitted to Changzhou Third People's Hospital from January 2022 to February 2023 were selected for the randomized controlled trial,and were divided into an experimental group and a control group by the random number table method,with 50 cases in each group.There were 42 males and 8 females in the control group;they were(46.60±14.63)years old.There were 46 males and 4 females in the experimental group;they were(46.24±15.71)years old.The control group were manually injected saline;the experimental group received modified electrocardiogram guided localization.After catheter placement,the catheter in position rates,ectopic rates during placement,the positioning times,incidences of complications,and patient satisfaction were compared between the two groups.t andχ^(2) tests were applied.Results The PICC in position rate and patient satisfaction in the experimental group were higher than those in the control group[98.0%(49/50)vs.82.0%(41/50)and 98.0%(49/50)vs.80.0%(40/50)];the incidence of complications in the experimental group was lower than that in the control group[10.0%(5/50)vs.30.0%(15/50)];the positioning time in the experimental group was shorter than that in the control group[(17.56±1.64)s vs.(33.22±2.75)s];there were statistical differences(χ^(2)=7.111,8.274,and 6.250;t=32.604;all P<0.05).There was no statistical difference in the ectopic rate during placement between the experimental group and the control group[2.0%(1/50)vs.6.0%(3/50)],with no statistical difference(χ^(2)=1.042,P=0.307).Conclusion Application of modified electrocardiogram guided localization in HIV patients is safe,accurate,economical,and practical to improve patient satisfaction and reduce the incidence of complications after catheterization.