CT成像在提高中心静脉导管术再次置管成功率中的作用  

The role of CT imaging in improving the success rate of PICC recatheterization

作　　者：贺锋[1] 顾红[2] 肖雪月[2] 葛雨曦 

机构地区：[1]无锡市第四人民医院江南大学附属医院影像科,214062 [2]无锡市第四人民医院江南大学附属医院肿瘤内一科,214062

出　　处：《实用医学影像杂志》2017年第2期138-141,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨CT对首次PICC管置管失败患者再次置管的引导价值。方法选择本院2013年3月至2016年10月需要行经外周静脉置入中心静脉导管术(PICC)管穿刺、但首次X线片显示PICC管不在位的患者共63例,至PACS工作站调取患者2周内胸部CT,按有无胸部CT分为观察组35例和对照组28例,对观察组的胸部CT进行阅片后调整导管位置,对照组无胸部CT资料亦重新调整导管位置;对两组重新置管的结果行X线片进行评估,比较其成功率。结果观察组35例重新置管后34例置管成功;对照组28例5例重新置管成功;观察组及对照组重新置管成功率分别为97%和18%,χ~2检验具有统计学意义。分析观察组失败原因有三类:第一,操作不当5例;第二,PICC管置管通路结构变异13例;第三,置管通路出现肿瘤压迫造成置管失败8例。结论胸部CT检查在分析PICC管置管失败原因同时,对再次置管具有指导意义,值得临床进一步推广。Objective To study the CT in patients with PICC tube insertion failure for the first time to guide the value of the again. Methods In our hospital in March 2013 - October 2016 need a PICC line pipe piercing, but for the first time X-ray scans showed a total of 63 patients with PICC tube is not a, to PACS workstation patients chest CT within two weeks, to be obtained by the presence of chest CT were divided into observation group （n=35） and the control group （n=.~8）, the observation group of chest CT to adjust the position, after reading the control without chest CT data and readjust the position; The results of two groups to buy tube line to evaluate X ray film, compare the success rate. Results Observation group of 35 cases to 34 cases after catheter insertion success; 28 cases in the con- trol group 5 cases catheter again success; Observation group and control group to buy tube success rate were 97.1% and 17.9% respectively, chi-square test of statistical significance. Reasons for failure analysis group has three cate- gories： first, the improper operation in 5 cases; Second, PICC tube catheter pathway structure variation in 13; Third, catheter pathway in tumor oppression causing 8 cases of tube failure. Conclusion The chest CT examination at the same time, analyzing the reason for failure to PICC tube insertion has a guiding significance to once again, is worth further promotion in the clinical practice.

关 键 词：导管插入术 中心静脉 多探头的计算机断层扫描 护理评估 

分 类 号：R472[医药卫生—护理学]