高频彩色多普勒超声在经外周静脉置入中心静脉导管置管术后随访中的应用  

Application of high-frequency color Dopplor ultrasound in checking venous thrombosis after peripherally insertion of central catheter

作　　者：熊华花[1] 李泉水[1] 许晓华[1] 陈胜华[1] 邹霞[1] 

机构地区：[1]深圳大学第一附属医院超声科,广东深圳518035

出　　处：《中国介入影像与治疗学》2012年第5期343-345,共3页Chinese Journal of Interventional Imaging and Therapy

基　　金：深圳市医学重点专科资助项目(No2005C06)

摘　　要：目的探讨高频彩色多普勒超声在经外周静脉置入中心静脉导管(PICC)置管术后随访中的应用价值。方法对87例接受PICC的患者行彩色多普勒超声检查,从置管处静脉向近心端追踪,显示肘正中静脉、贵要静脉或头静脉、锁骨下静脉、头臂静脉、上腔静脉及颈内静脉,观察导管在血管内的位置及走向、导管壁是否呈规整的平行线状回声、置管部位是否受压、静脉管腔内径及血流状态,尤其注意观察是否有血栓形成及血栓形成的部位、累及范围、血流通畅情况。结果 87例中60例清晰显示平行管状回声,管腔通畅,无血栓形成,27例不同部位管腔内有血栓形成,静脉增宽,内可见低回声充填,管腔部分或完全闭塞,血流信号变窄、不规则或完全无血流信号。其中3例伴有颈内静脉血栓形成,管腔完全闭塞。结论 PICC置管术后血栓形成是其主要的并发症,超声可对PICC置管术后患者进行随访观察,及早发现导管脱落或血栓形成。Objective To investigate the value of high-frequency color Dopplor ultrasound in checking venous thrombosis after peripherally inserted central catheter （PICC）. Methods High-frequency color Doppler ultrasound was performed in 87 patients who underwent PICC. The ipsilateral median cubital vein, basilic vein, cephalic vein, subclavian vein and jugular vein were checked, and the catheters in the venous, venous flow status, and the location and length of thrombosis were observed. Results The venous were unobstructed without thrombosis in 60 patients, while thrombosis were found in 27 patients at different veins with widened lumen and hypoechoic spots, color Doppler ultrasound showed narrowing, irregular of the lumen or disappeared blood flow signal. There was thrombus in jugular vein causing completely occlusion in 3 cases. Conclusion Thrombosis is the main postoperative complication after PICC. High-frequency ultrasound can be used to early detect loss of catheters or thrombosis formation.

关 键 词：经外周静脉置入中心静脉导管 超声检查 多普勒 彩色 静脉血栓形成 

分 类 号：R543.6[医药卫生—心血管疾病] R445.1[医药卫生—内科学]