不同中心静脉置管方式致导管末端异位的比较及分析  

Comparison and analysis of tip malposition after different central venous catheterizations

作　　者：谢俊英 代忠 陈燕 商卫娜 丁一妹[4] 高建川 王绿化[6] 

机构地区：[1]北京市朝阳区桓兴肿瘤医院静脉置管室,北京100005 [2]北京市朝阳区桓兴肿瘤医院综合科,北京100005 [3]北京市朝阳区桓兴肿瘤医院护理部,北京100005 [4]中国人民解放军总医院南楼心血管一科,北京100853 [5]北京市朝阳区桓兴肿瘤医院外科,北京100005 [6]中国医学科学院肿瘤医院肿瘤研究所放疗科,北京100029

出　　处：《实用临床医药杂志》2014年第22期1-4,共4页Journal of Clinical Medicine in Practice

基　　金：北京市朝阳区科委科技计划项目资助(SF1217);中国高校医学期刊临床专项资金(11321566)

摘　　要：目的比较肿瘤患者外周静脉置入中心静脉导管(PICC)与传统中心静脉导管(CVC)2种置管导管末端异位情况。方法选择1656名共1799例次PICC/CVC置管后的肿瘤患者,常规胸部正位X线检查确认置管走向及导管末端位置,计算导管末端异位发生率,对导管末端异位者进行调整并观察转归。结果 PICC置管失败率2.68%,CVC置管失败率0.34%,2组比较差异显著(P<0.01)。胸部X线检查导管末端异位发生率4.84%,其中PICC末端异位发生率6.42%,显著高于CVC末端异位发生率4.01%(P<0.01)。PICC末端异位调整成功率为71.1%,CVC末端异位调整成功率为26.7%,2组比较差异显著(P<0.01)。结论与CVC置管相比,肿瘤患者PICC置管导管末端异位发生率较高,但较容易调整。PICC/CVC置管后应常规胸部正位X线片确认导管走向和导管末端位置。Objective To compare and analyze tip malposition of 2 central venous catheteri-zations in cancer patients.Methods Totally 1656 cancer patients received 1799 cases of peripheral-ly inserted central catheter（PICC）/conventional central venous catheter（CVC）were consecutively assessed by means of routine post-catheterization chest X-ray.The catheter with its tip strike and terminal position were confirmed individually.All tip malpositions were calculated.And the catheters with tip malpositions were readjusted and reevaluated.Results The failure rate in PICC group （2.68%）was significantly higher than that in CVC group（0.34%,P 〈0.01）.Eighty three catheters（4.84%）were found tip malpositioned,in which 38 catheters（6.42%）were from PICC group and 45 ones（4.01%）from CVC group （P 〈0.01）.The achievement ratio of readjustment for tip malposition in PICC group （71.1%）was much higher than that in CVC group （26.7%,P〈0.01）.Conclusion Compared with CVCs in cancer patients,the prevalence of tip malposition from PICCs was higher although the tip malpositions in PICCs were more likely to be corrected with readjustment.These findings suggest that tip position of PICC /CVC should be confirmed post-catheterization with chest x-ray.

关 键 词：外周静脉置入中心静脉导管 中心静脉导管 介入治疗 并发症 

分 类 号：R472[医药卫生—护理学]