彩色多普勒超声引导PICC成功率及发生并发症原因的分析  

Analyse the reason of success rate and its complications in patients with peripherally inserted central catheter under the guidance of color doppler ultrasound

作　　者：徐韶华[1] 吴明双[1] 潘辑[1] 周晓东[1] 王雷[1] 柳标[1] 

机构地区：[1]上海交通大学医学院苏州九龙医院超声科,江苏苏州215021

出　　处：《中国医药科学》2015年第7期162-165,共4页China Medicine And Pharmacy

摘　　要：目的分析彩色多普勒超声引导外周静脉植入中心静脉导管(PICC)成功率及其并发症形成的原因。方法 151例PICC患者,均行超声引导下经上肢浅静脉(贵要静脉)植入静脉导管,且拔管前超声常规检查置管静脉。结果 (1)151例患者贵要静脉内径>2mm的148例,其中,141例贵要静脉主干明显且经腋静脉、锁骨下静脉至上腔静脉,一次性成功植入静脉导管132例(132/148,占89.19%),9例(9/148,占6.08%)因操作原因失败,另7例(7/148,占4.73%)贵要静脉主干不明显未能植入上腔静脉而入皮下浅静脉;其余3例患者贵要静脉内径<1.8mm,均未能成功植入静脉导管。(2)132例成功PICC患者,临床静脉给药治疗结束,拔管前超声检查15例(15/132,占11.36%)静脉导管周和(或)静脉壁形成血栓,回顾发现该类患者静脉导管沿导丝植入前均用碘伏擦拭消毒。结论贵要静脉内径、走形及正确的操作是PICC成功的因素,碘伏消毒静脉导管可导致静脉血栓形成,超声引导对PICC具有重要作用。Objective To analyze the reason of success rate and its complications in patients with peripherally inserted central catheter （PICC） under ultrasound guidance.Methods Clinical PICC 151 patients were performed under ultrasound guided by upper extremity superficial vein （basilic vein） veins tube, and before extubation ultrasound catheter vein in a regular examination.Results（1）151 cases of patients with 148 basilic vein inner diameter 〉2mm, among of 148, 141 cases of venous trunk head clear and via the axillary vein, subclavian vein first vena cava, one-time successful veins were 132 cases （132/148, 89.19%）, and 9 failed for operating reasons （9/148, 6.08%）, the other 7 basilic vein trunk unclear not implanted in the superior vena cava but in subcutaneous superficial vein （7/148, 4.73%）, The rest 3 cases of basilic vein diameter〈1.8 mm were failed to implant. （2）132 patients successfully implanted venous duct after clinical intravenous medication.15 cases （15/132, 11.36%%） week of venous duct and/or venous wall thrombosis by ultrasonic examine before extubation, review found that these patients vein tube along the thread implant before using iodine volts to wipe disinfection.ConclusionInner diameter and contorts the basilic vein and the right operation are factors in the success of PICC, iodine volts disinfection vein tube could lead to venous thrombosis, ultrasound is an important role in guiding PICC.

关 键 词：彩色多普勒超声 引导 外周静脉植入的中心静脉导管 成功率 并发症 

分 类 号：R445.1[医药卫生—影像医学与核医学]