新生儿中心静脉腔内心电图P波大小与导管尖端位置关系的研究

The relationship between P wave of introcavitary-ECG in central venous of neonatal and the position of peripherally inserted central catheter tip

目的 探讨静脉内ECG引导PICC尖端定位的准确性和安全性.方法 将2014年6月至2015年3月行PICC置管早产儿50例作为观察组,2012年8月至2014年5月50例是回颐性病例作为对照组,对照组按传统方法行PICC置管后X线摄片确定导管位置.观察组在心电监护下置管,通过监护心电Ⅱ导联P波的变化确定导管位置.导管固定后行X线摄片检查确定导管尖端位置.结果 对照组一次置管成功率74％(37/50),显著低于观察组94％(47/50),差异有统计学意义(X2=7.440,P＜0.05).结论 ECG技术能够提高一次性置管成功率,提高工作效率,降低护理操作风险.

Objective To explore the accuracy and security of introcavitary-ECG guiding peripherally inserted central catheter (PICC) tip positioning.Methods The observation group was defined as the 50 preterm infants who was cathetered PICC between June 2014 to May 2015 while the control group as the other 50 cases was cathetered between August 2012 to May 2014 to review.The latter group was cathetered traditionally and positioned by X-ray while the former was cathered by ECG-monitoring and positioned by the change of P wave on ECG-Ⅱ.X-ray was also used to confirm the PICC tip positioning when the cathere was fixed in the control group.Results The success rate of first puncture in control group was 74％(37/50),significatly lower than the observation group,which was 94％(47/50) (x2=7.440,P ＜ 0.05).Conclusions The technology of ECG makes benefits in increasing the success rate of first puncture,reducing cathetering time,improving work efficiency,reducing the risk of nursing operation and garanteeing security of nurses and patients.