Background and Objective: Percutaneous central venous cannulation is a common invasive procedure. In comparison with an external landmark technique, the advantages of ultrasound-guided venous access include direct vis...Background and Objective: Percutaneous central venous cannulation is a common invasive procedure. In comparison with an external landmark technique, the advantages of ultrasound-guided venous access include direct visualization of the anatomy and in vivo visualization of venous cannulation. Methods: We evaluated an ultrasound-guided technique for infraclavicular axillary vein cannulation, focusing on its ease of use, success rate and complications rate. One hundred and twenty patients who submitted to central venous catheter placement were punctured using our technique. The patients were positioned so that their ipsilateral upper limb was abducted at 90° to the longitudinal axis, which makes it possible to visualize the infraclavicular vessels due to the elevation of the clavicle, thereby improving accessibility. Results: Cannulation was successful in all patients. The median time from the start of the first puncture (of the skin) until the aspiration of blood was 15 s (range 7 - 135 s). Both infraclavicular axillary veins were cannulated, and the vein was punctured successfully at the first attempt in 95% of the patients, without complications during the procedure. Conclusion: We propose an ultrasound-guided infraclavicular approach of the axillary vein, with a high success rate and no complications in the present cohort.展开更多
目的探讨超声引导下经外周置入中心静脉导管(peripherally inserted central catheter,PICC)在新生儿穿刺困难中的临床应用。方法选取2019年1月至2021年4月于昆明市儿童医院新生儿科同一组专业的PICC管理团队小组评估为穿刺困难的104例...目的探讨超声引导下经外周置入中心静脉导管(peripherally inserted central catheter,PICC)在新生儿穿刺困难中的临床应用。方法选取2019年1月至2021年4月于昆明市儿童医院新生儿科同一组专业的PICC管理团队小组评估为穿刺困难的104例新生儿为研究对象,将其随机分为观察组和对照组,每组各52例。对照组采取传统盲穿置管,观察组采取超声引导下置管,比较2组患儿在穿刺次数、留置时间、一次性穿刺成功率、一次性置管成功率、留置时间等方面的差异。结果观察组的平均穿刺次数以及置管时间均少于对照组;观察组一次性穿刺成功率、一次性置管成功率均高于对照组;观察组留置时间长于对照组;差异均有统计学意义(P<0.05)。观察组穿刺时周围组织损伤、经皮氧饱和度下降的发生率均低于对照组;观察组穿刺后维护期并发症的总发生率低于对照组;差异有统计学意义(P<0.05)。结论穿刺困难新生儿行PICC时,经超声引导,在穿刺过程中可有效减少穿刺次数及置管时间,提高一次性穿刺成功率及一次性置管成功率,并且增加了留置时间,值得临床推广。展开更多
目的:分析超声引导腔内心电图技术对肿瘤患者经外周静脉穿刺中心静脉置管(peripherally inserted central venous catheters,PICC)一次性置管成功率与并发症的影响。方法:选取2021年6月—2022年12月于广西科技大学第二附属医院行PICC置...目的:分析超声引导腔内心电图技术对肿瘤患者经外周静脉穿刺中心静脉置管(peripherally inserted central venous catheters,PICC)一次性置管成功率与并发症的影响。方法:选取2021年6月—2022年12月于广西科技大学第二附属医院行PICC置管的肿瘤患者428例作为研究对象,按照随机数字表法将其分为对照组(214例)与研究组(214例)。两组患者均接受PICC置管,其中对照组采用超声引导置管,研究组采用超声引导腔内心电图技术置管。记录并比较两组患者PICC导管尖端到位率、置管异位率、一次性置管成功率、置管成功时间、视觉模拟评分法(VAS)评分、置管相关并发症发生情况及护理满意度。结果:研究组导管尖端到位率、置管异位率、一次性置管成功率均高于对照组,差异均有统计学意义(P<0.05)。研究组PICC置管成功时间短于对照组,差异有统计学意义(P<0.05);研究组VAS评分低于对照组,差异有统计学意义(P<0.05)。研究组PICC置管相关并发症发生率低于对照组,差异有统计学意义(P<0.05)。研究组护理总满意率高于对照组,差异有统计学意义(P<0.05)。结论:超声引导腔内心电图技术可以有效提高肿瘤患者PICC一次性置管成功率,降低并发症风险,适于临床应用及推广。展开更多
文摘Background and Objective: Percutaneous central venous cannulation is a common invasive procedure. In comparison with an external landmark technique, the advantages of ultrasound-guided venous access include direct visualization of the anatomy and in vivo visualization of venous cannulation. Methods: We evaluated an ultrasound-guided technique for infraclavicular axillary vein cannulation, focusing on its ease of use, success rate and complications rate. One hundred and twenty patients who submitted to central venous catheter placement were punctured using our technique. The patients were positioned so that their ipsilateral upper limb was abducted at 90° to the longitudinal axis, which makes it possible to visualize the infraclavicular vessels due to the elevation of the clavicle, thereby improving accessibility. Results: Cannulation was successful in all patients. The median time from the start of the first puncture (of the skin) until the aspiration of blood was 15 s (range 7 - 135 s). Both infraclavicular axillary veins were cannulated, and the vein was punctured successfully at the first attempt in 95% of the patients, without complications during the procedure. Conclusion: We propose an ultrasound-guided infraclavicular approach of the axillary vein, with a high success rate and no complications in the present cohort.
文摘目的探讨超声引导下经外周置入中心静脉导管(peripherally inserted central catheter,PICC)在新生儿穿刺困难中的临床应用。方法选取2019年1月至2021年4月于昆明市儿童医院新生儿科同一组专业的PICC管理团队小组评估为穿刺困难的104例新生儿为研究对象,将其随机分为观察组和对照组,每组各52例。对照组采取传统盲穿置管,观察组采取超声引导下置管,比较2组患儿在穿刺次数、留置时间、一次性穿刺成功率、一次性置管成功率、留置时间等方面的差异。结果观察组的平均穿刺次数以及置管时间均少于对照组;观察组一次性穿刺成功率、一次性置管成功率均高于对照组;观察组留置时间长于对照组;差异均有统计学意义(P<0.05)。观察组穿刺时周围组织损伤、经皮氧饱和度下降的发生率均低于对照组;观察组穿刺后维护期并发症的总发生率低于对照组;差异有统计学意义(P<0.05)。结论穿刺困难新生儿行PICC时,经超声引导,在穿刺过程中可有效减少穿刺次数及置管时间,提高一次性穿刺成功率及一次性置管成功率,并且增加了留置时间,值得临床推广。
文摘目的:分析超声引导腔内心电图技术对肿瘤患者经外周静脉穿刺中心静脉置管(peripherally inserted central venous catheters,PICC)一次性置管成功率与并发症的影响。方法:选取2021年6月—2022年12月于广西科技大学第二附属医院行PICC置管的肿瘤患者428例作为研究对象,按照随机数字表法将其分为对照组(214例)与研究组(214例)。两组患者均接受PICC置管,其中对照组采用超声引导置管,研究组采用超声引导腔内心电图技术置管。记录并比较两组患者PICC导管尖端到位率、置管异位率、一次性置管成功率、置管成功时间、视觉模拟评分法(VAS)评分、置管相关并发症发生情况及护理满意度。结果:研究组导管尖端到位率、置管异位率、一次性置管成功率均高于对照组,差异均有统计学意义(P<0.05)。研究组PICC置管成功时间短于对照组,差异有统计学意义(P<0.05);研究组VAS评分低于对照组,差异有统计学意义(P<0.05)。研究组PICC置管相关并发症发生率低于对照组,差异有统计学意义(P<0.05)。研究组护理总满意率高于对照组,差异有统计学意义(P<0.05)。结论:超声引导腔内心电图技术可以有效提高肿瘤患者PICC一次性置管成功率,降低并发症风险,适于临床应用及推广。
