腔内心电图引导PICC置管在重度烧伤康复期患者瘢痕皮肤中的应用  

Application of PICC catheter guided by intracardiac electrocardiogram in patients with severe burn injury

作　　者：樊小朋[1] 任青[1] 吴银华[1] 徐彩琴[1] Fan Xiaopeng Ren Qing Wu Yinhua Xu Caiqin.(Department of Nursing, Kunshan Hospital Affiliated to Jiangsu University, Kunshan 215300, China)

机构地区：[1]江苏大学附属昆山医院护理部,215300

出　　处：《中国实用护理杂志》2017年第26期2033-2036,共4页Chinese Journal of Practical Nursing

摘　　要：目的探讨腔内心电图辅助定位超声引导下PICC置管在重度烧伤康复期患者瘢痕皮肤中的应用及护理。方法利用腔内心电图辅助定位对12例烧伤面积〉95％的烧伤患者在瘢痕增生皮肤处行超声下PICC置管进行静脉输液治疗。结果10例患者在肘上经贵要静脉PICC置管一次性穿刺成功，1例导管在右侧上臂贵要静脉成功送入血管鞘内导丝后因瘢痕皮肤扩皮不到位导致血管鞘前段受损导丝弯曲无法成功放入导管，改为左上臂贵要静脉置管成功，1例导管因最初穿刺时穿刺者经验不足在成功穿刺放入导丝后退穿刺针时因瘢痕皮肤针眼松弛未将导丝固定使导丝一起带出导致二次穿刺，12例导管尖端位置经X线显示均在上腔静脉下1／3处，留置的时间为3—11个月，在留置期间无相关并发症发生。结论采用腔内心电图辅助定位PICC置管在重度烧伤康复期患者瘢痕皮肤中的应用具有可行性及优势。Objective To explore the application and nursing care of patients with severe burn patients with scar skin treated by ultrasound-guided PICC catheter placement. Methods Twelve patients with burn area of more than 95% were treated with intravenous catheter placement of PICC under the condition of scar hyperplasia skin with the help of ecg. Results Ten patients in elbow basilic vein catheterization by PICC disposable puncture, 1 cases of catheter in the right upper arm of the basilic vein into vascular sheath scar after guidewire dilating the skin in place leading to vascular sheath damaged anterior guidewire failed in bending catheter, to your left arm to venous catheter success, 1 cases of catheter for initial puncture puncture into the insufficient experience in successful puncture needle when the guide wire back because of scar skin relaxation will not needle guide wire fixing the wire with a lead to two times of puncture, 12 cases of catheter tip position by X-ray showed in the superior vena cava under 1/ 3, indwelling time ranged from -11 months of March, in the retention period without related complications. Conclusions It is feasible and advantageous for the application of PICC catheter in the treatment of severe burn patients with scar skin.

关 键 词：护理 腔内心电图 重度烧伤 瘢痕皮肤 PICC置管 

分 类 号：R473.6[医药卫生—护理学]