腔内心电图联合超声探查在PICC定位中的应用  

Intracavitary electrocardiogram and ultrasonography in PICC positioning application

作　　者：汪华萍[1] 杨利霞[1] 石岚[1] 章玉英[1] 邱娟[1] 黄秀兰[1] 

机构地区：[1]江西省肿瘤医院,南昌市330029

出　　处：《护理实践与研究》2016年第4期114-116,共3页Nursing Practice and Research

摘　　要：目的：探讨腔内心电图联合超声探查在PICC定位中的应用效果。方法：选择2014年1~12月来我院静脉置管室置管的患者1891例,将其随机分为观察组946例和对照组945例。观察组在导管送至预置入长度后,使用心电监护仪进行定位,对于未出现特征性P波的患者,使用超声探头对同侧颈内静脉、颈外静脉、腋静脉以及锁骨下静脉进行排查;对照组在导管送至预置入长度后,直接使用超声探头对同侧颈内静脉、颈外静脉、腋静脉以及锁骨下静脉进行排查,两组患者均在超声探查排除异位后,将导管妥善固定。操作结束后协助患者行X线摄片,比较两组患者导管尖端到位率、置管所需时间以及出现特征性P波的患者与X线定位结果的吻合率。结果：观察组患者导管尖端到位率高于对照组,差异有统计学意义（P〈0.05）,置管所需时间短于对照组,差异有统计学意义（P〈0.05）,观察组出现阳性特征的患者与X线定位结果的吻合率100%。结论：应用腔内心电图联合超声探查定位方法可以有效地减少异位,是一种高效、可靠的PICC尖端定位方法,值得临床推广应用。Objective：To investigate in!racavitary electrocardiography combined effect of ultrasonography in the positioning of the PICC. Methods： The 1891 cases of patients in our department with intravenous catheter tube from January to December 2014 were randomly divided into two groups, 946 cases in the observation and 945 cases in the control group. Observation group in the catheter to send to the preset into the length, ECG monitor position, for patients without characteristic p wave using ultrasonography to carry out the investigation of ipsilateral internal jugular vein, external jugular vein and axillary vein and subclavian vein ; Control group in the catheter to send to the preset into the length, directly used the ultrasonography to carry out the investigation of ip- silateral internal jugular vein, external jugular vein and axillary vein and subclavian vein, two groups of patients were in ultrasonography excluded the ectop- ic, the catheter was properly fixed. After the end of the operation to assist patients with X - ray, two groups were compared the rate of catheter tip position, catheter and the emergence of the patient and the time required for the X - ray positioning results consistent rate characteristic P waves. Results ： Patients place the tip of the catheter rate in the observation group was higherthan the control group, the difference was statistically significant （ P 〈 0.05 ）, catheter time was shorter than the control group, the difference was statistically significant （ P 〈 0.05 ）, observation group had positive characteristics of the patients with the X - ray localization results consistent rate of 100%. Conclusion： Ultrasound intracavitary electrocardiography combined positioning method can ef- fectively reduce ectopic, it is an efficient, reliable PICC tip location methods, worthy of clinical application.

关 键 词：腔内心电图 超声探查 PICC定位 临床应用 

分 类 号：R472[医药卫生—护理学]