不同体位PICC置管术导管异位情况的观察分析  

Observation and analysis of malposition of catheter during PICC at different body positions

作　　者：郭梅[1] 汪丹[1] 穆婷婷[1] 周晶[1] 许宗仪[1] 

机构地区：[1]解放军总医院肿瘤内科,北京100853

出　　处：《中国实用护理杂志》2012年第23期46-47,共2页Chinese Journal of Practical Nursing

摘　　要：目的拟探讨不同的体位配合歪头动作置管术后导管异位的发生情况，以期选择出适合的体位，提高置管成功率。方法将155例置管的患者随机分为平卧位组55例、半卧位组49例、坐立位组51例，均采用标准的PICC置管方法。平卧位组患者取平枕仰卧位，半卧位组患者取床头抬高约30°，坐立位组患者取坐位900，置管后均拍X线胸部正位片，确定导管尖端位置，比较3组间的导管异位的发生情况。结果共有11例患者发生导管异位，其中半卧位组8例占16．3％，平卧位组2例占3．6％，坐立位组1例占1．9％，半卧位组与其他2组导管异位发生率比较差异显著。结论PICC置管术中患者取平卧位是最佳选择，只有当患者伴有呼吸困难或导管异位需要调整时采用坐立位，不推荐床头抬高300的半卧位体位。Objective To study the incidence of malposition of catheter at different body positions during the operation of peripherally inserted central catheter （PICC）, and then select the optimum position to increase the success rate of insertion. Methods 155 patients were randomly divided into the horizontal position group （55 cases）, the semi-reclining position group （49 cases） and the sitting position group （51cases）. They all used chest X-ray to conffirm the position of top end of the catheter after insertion and then comparing the incidence rate of malposition of catheter among three groups. Results After insertion, 11 patients＇ catheters were found malposition. Among them, 8 patients were in the semi-reclining position group （incidence rate 16.3%）, 2 patients were in the horizontal position group （incidence rate 3.6%） and only one patient was in the sitting position group （incidence rate 1.9%）. Incidence rate of catheter malposition in the semi-reclining position group was significantly higher than other two groups. Conclusions The best position for PICC is the horizontal position. If the patient has expiratory dyspnea or need to adjust the malposition catheter, sitting position can be used. Semi-reclining position should be avoided in the operation of PICC.

关 键 词：体位 经外周静脉置入中心静脉导管 导管异位 

分 类 号：R472[医药卫生—护理学]