护理会诊行超声引导下经外周静脉穿刺的中心静脉导管置管82例  

Analysis of 82 cases applied for nursing consultation on bedside ultrasound -guided peripherally inserted central catheter catheterization

作　　者：张雪花[1] 李雅婧[1] 张潆化[1] 郭玉娇[1] 赵丽娟[1] 李燕[1] 

机构地区：[1]中国人民解放军总医院,100853

出　　处：《实用医技杂志》2013年第5期495-496,共2页Journal of Practical Medical Techniques

摘　　要：目的为提高疑难病例经外周静脉穿刺的中心静脉导管(PICC)置管成功率提供技术支持与经验指导。方法对82例疑难病例进行护理会诊行床旁超声引导下PICC置管术的会诊原因进行总结分析。结果 82例患者中39例穿刺失败后请求会诊,评估为无法实施盲穿,直接申请会诊43例。置管成功80例,置管成功率98%。结论提高疑难病例会诊置管成功率的八个关键点:选择最佳置管方式与时机、特殊病例置管前预见性处理、构建力学三角、临终患者动静脉识别与选择、局麻时机、判断穿刺成功方法、扩皮技巧及导管颈内静脉异位的诊断与鉴别。Objective To analyze difficulty cases with care consultation on bedside ultrasound-guided peripherally inserted central catheter （PICC） catheterization. Methods A retrospective analysis of 82 cases applied for PICC catheterization between October 2010 and December 2011. The consultation reason and constituent ratio were included. Results Thirty-nine cases applied for consultation after puncture failure, 43 cases applied for consultation directly. Eighty cases were success; the success rate was 98%. Conclusion The key points of technique include： choosing the best way and time of catheterization, foresight processing special cases, constructing mechanics triangle, identifying artery and vein of terminal patients, selecting local anesthesia time, judging puncture success, and diagnosis ectopic catheter inside of internal jugular vein. Experienced technical guidance can improve the success rate of PICC catheterization of difficult case.

关 键 词：护理 导管插入术 中心静脉导 治疗结果 

分 类 号：R472[医药卫生—护理学]