改良塞丁格引导的PICC临床应用  

Clinical Application of PICC under the Guidance of the Modified Seldinger Technique

作　　者：郑海燕[1] 陈桂华[2] 

机构地区：[1]安徽省蚌埠医学院第一附属医院肿瘤内科,233004 [2]安徽省蚌埠医学院第一附属医院护理部,233004

出　　处：《中华全科医学》2011年第3期477-478,共2页Chinese Journal of General Practice

摘　　要：目的探讨改良塞丁格引导的PICC临床应用效果。方法选取2010年4～8月经蚌医一附院PICC组核心护士会诊后认为无法应用传统方法置入PICC患者7例,其中2例为传统方法置入PICC失败,形成局部血肿,2例因肥胖或先天静脉条件差,3例因长期治疗、反复穿刺致肘部静脉弹性差,视觉和触觉均难以辨认静脉深浅和走向,而中心静脉置管(CVC)无法满足疗程需要。应用改良塞丁格引导的PICC技术。结果 7例患者均一次成功,成功率100%,其中从贵要静脉置入6例,正中静脉置入1例,后拍片显示导管头端位置均在上腔静脉内,操作安全,输液通畅,导管留置期间无并发症发生。结论应用改良塞丁格引导技术,提高了PICC的置管成功率,扩大PICC适应症,该技术能有效解决传统方法无法置入PICC管的问题,提升护理质量,减轻患者痛苦,避免资源浪费。Objective To investigate clinical effect of PICC under guidance of the modified seldinger technique. Methods From Apr to Aug in 2010,7 patients were selected,they were considered by PICC core group of nurses in our hospital that traditional PICC placement could not be applied to them,2 cases failed to PICC insertion by traditional methods with the formation of local hematoma ,2 cases with poor conditions of obesity or congenital venous ,3 cases with long-term therapy and repeated puncture caused by poor flexibility in the elbow vein. It was difficult to identify by visual and tactile the depth and direction of the vein, and the central venous catheter（CVC） can not met the treatment needs. PICC insertion tube was used under guidance of the modified seldinger technique. Results 7 patients were all successful at one time,the sueeess rate was 100% , and 6 cases were inserted from the basilic vein, 1 case from the median vein. The film showed that all catheter＇ s headends were in the superior vena cava, operations were safe, infusion was smooth, no complications occurred during the catheters indwelling. Conclusion Under guid- ance of the modified seldinger technique, the success rate of PICC was improved,the indications for PICC were expanded,this technology can effectively solve the problems can not be settled by the traditional way of PICC, it can enhance the quality of eare and reduce patients＇ suffering, and avoid waste of resources.

关 键 词：改良塞丁格(MST) PICC 护理 

分 类 号：R472.9[医药卫生—护理学] R473.73[医药卫生—临床医学]