肿瘤患者PICC导管异位状况及相关因素调查  

Investigation of the status and related factors on tumor patients＇ PICC misplacement

作　　者：张玉珍[1] 苏迅[2] 刘菊琴[1] 董雪[1] 张芳[1] 

机构地区：[1]空军总医院肿瘤内科,北京100142 [2]空军总医院护理部,北京100142

出　　处：《中华现代护理杂志》2012年第26期3129-3131,共3页Chinese Journal of Modern Nursing

摘　　要：目的调查PICC置管时导管异位的原因和纠正方法并分析其相关因素。方法分析354例肿瘤患者行PICC置管时32例导管异位发生的相关因素，在未拔导丝前予以正位。结果导管异位发生在年龄〉60岁者较≤60岁者多，差异具有统计学意义（χ2=4．733，P〈0．05）；87．5％发生于置管侧静脉中；左上肢置管的异位率较右上肢者高，差异具有统计学意义（χ2=7．552，P〈0．01）；头静脉置管者异位率为15.79％，而肘正中静脉和贵要静脉置管者分别为8．89％和8．12％。导管异位率与患者的性别、穿刺方法及病变部位无关，差异无统计学意义（P〉0．05）。32例异位者正位均获成功。结论娴熟的技术是置管成功的保证，对高龄患者置管要谨慎，尽量选择右上肢静脉置管，以贵要静脉为首选，次之为肘正中静脉。带导丝立即在X线下视导管异位的具体情况，变动患者体位并随其吸气不失时机地正位。Objective To explore the reason and remedy on tumor patients＇ PICC misplacement. Methods The reason of 32 tumor patients＇ PICC misplacement were analyzed. The patients whose PICC misplaced were observed by X-ray, and then regulated to precava before remove the wire. Results PICC misplacement was much more observed in patients who was sixty years old or above than that of their younger counterpart （χ2 =4.733, P 〈 0.05 ）. 87.5% of PICC misplacement were observed in the ipsilateral vein and less observed in right upper extremity （ χ2 = 7. 552, P = 0. 006）. The rate of PICC misplacement of cephalic vein, median cubital vein and basilic vein respectively were 15.7% , 8.89% and 8.12%. And there was no significant difference was detected in the gender, method and the location of cancer （ P 〉 0.05 ）. Finally, all the misplacement PICC were regulated to the right place. Conclusions Adept technology makes success, and more attention should pay to elderly patients. It is better to insert PICC in patient＇ s right upper extremity, especially basilic vein, and then median cubital vein. Utilize the X-ray to adjust patients position, and matching inspiration to adjust PICC ＇ s location in order to avoid misplacement.

关 键 词：恶性肿瘤 PICC 导管异位 相关因素 

分 类 号：R473.73[医药卫生—护理学]