超声引导下结合改良塞丁格技术对化疗患者不同深度血管PICC置管的影响  

The influence of ultrasonic guidance in combination of the modified Seldinger technique on the PICC catheterization into the blood vessel of different depths for patients undergoing chemotherapy

作　　者：吴秀玲[1] 潘玉芹[1] 

机构地区：[1]安徽医科大学第一附属医院肿瘤内科,合肥市230032

出　　处：《护理实践与研究》2016年第7期4-6,共3页Nursing Practice and Research

摘　　要：目的：探讨在超声引导下运用改良塞丁格技术对化疗患者进行PICC置管时的置管深度与一次置管成功率及并发症的关系。方法：选取2011年6月～2013年1月在我科住院的166例运用改良塞丁格技术进行PICC穿刺的化疗患者,对其临床资料进行回顾性分析,按照穿刺血管在B超上显示的深度分为A组（0.5 cm）、B组（1.0 cm）和C组（1.5 cm）。比较3组一次置管成功率及并发症发生率。结果：A组和C组一次置管成功率均低于B组,差异有统计学意义（P均〈0.05）;A组和C组间一次置管成功率差异无统计学意义（P〉0.05）。C组患者的穿刺点出血和渗液发生率均高于A组和B组,差异有统计学意义（均P〈0.05）,A组和B组间穿刺点出血和渗液发生率差异无统计学意义（P〉0.05）。3组患者的导管异位发生率差异无统计学意义（P〉0.05）。结论：置管血管深度为1.0 cm的患者一次置管成功率较高,术后并发症发生率低,置管血管深度为1.5 cm的患者置管后出血和渗液发生率较高。置管深度可能是一次置管成功率的影响因素。Objective： To explore the relation between the depth of the PICC catheterization,which is applied to patients undergoing chemotherapy under the ultrasonic guidance in combination of the modified Seldinger technique,and one- time catheterization success rate and the complications. Methods： Selected166 cases of patients undergoing chemotherapy who had received PICC puncture under the modified Seldinger technique in our department from June 2011 to January 2013,made retrospective analysis of their clinic documents and divided them into A group（ 0. 5 cm）,B group（ 1. 0 cm） and C group（ 1. 5 cm）according to the depths of the puncture blood vessels displayed on B- scan ultrasonography. Results： The one- time catheterization success rates of A group and C group were lower than that of B group and the difference had statistic significance（ average P〈0. 05）; the difference of one- time catheterization success rates between A group and C group had no significance（ P 〉0. 05）. The puncture points bleeding and seepage occurrence rate of C group was higher than the corresponds of the A group and C group,and the difference had statistic significance（ average P 〈0. 05）; while the difference between A group and C group of the puncture points bleeding and seepage occurrence rate had no statistic significance（ P 〉0. 05）. And the difference of catheter malposition occurrence rate among the three groups had no statistic significance（ P 〉0. 05）. Conclusion： The 1. 0 cm blood vessel depth catheterization leads to relatively higher one- time catheterization success rate and lesser postoperative complications. The catheterization depth is an intrinsic factor influencing the one- time catheterization success rate; when the catheterization depth reaches 1. 5 cm,the post- catheterization bleeding and seepage occurrence rate is relatively higher.

关 键 词：经外周静脉穿刺中心静脉置管 超声 塞丁格 化疗 并发症 

分 类 号：R473.73[医药卫生—护理学]