B超引导下经胸壁段腋静脉与PICC、颈内静脉置管准确性与安全性比较研究  

Comparative Study on the Accuracy and Safety of Transthoracic Axillary Vein and PICC,Internal Jugular Vein Under B-ultrasound Guidance

作　　者：郭玲 秦英 王国蓉 江群 郭琴 高丽 Guo Ling;Qin Ying;Wang Guorong(Research Institute of Sichuan Cancer Hospital, Sichuan Cancer Control Center, School of Medicine of University of Electronic Science and Technology ,Chengdu, Sichuan 610041, China)

机构地区：[1]四川省肿瘤医院.研究所四川省癌症防治中心电子科技大学医学院,四川成都610041

出　　处：《四川医学》2019年第2期155-158,共4页Sichuan Medical Journal

摘　　要：目的探讨B超引导下经腋静脉置入中心静脉导管的准确性和安全性。方法回顾性分析B超引导下经腋静脉、颈内静脉和手臂静脉三种途径中心静脉置管病例资料,比较三种置管途径置管成功率和置管相关并发症特点的差异。结果共1594例病例资料纳入研究,其中PICC组484例,经颈内静脉置入的CVC 902例,经胸壁腋静脉置入的CVC 208例。三组病例资料一次性穿刺置管成功率、一次以上穿刺成功率、一次性送管成功率差异有统计学意义(P<0.05),但三组一次以上送管成功率差异无统计学意义(P>0.05)。PICC、颈内静脉CVC和腋静脉置管过程中并发症发生率分别为0.6%(3例)、0.4%(4例)和5.3%(11例)。结论超声引导的胸壁段腋静脉置管穿刺成功率、送管成功率较高,与PICC、颈内静脉CVC相差不大,适合在有个体需求,有血管条件的肿瘤患者人群中开展。但应同时重点关注穿刺技术的精准性和并发症的预防以确保置管安全。Objective To investigate the accuracy and safety of central venous catheterization via axillary vein guided by B-ultrasound.Methods The data of patients with central vein indwelling via axillary vein,internal jugular vein and arm vein were analyzed retrospectively,and the differences of the success rate and complications of the three ways were compared.Results A total of 1594 cases were included in the study,including 484 cases in PICC group,CVC902 cases in internal jugular vein implantation and CVC208 cases in axillary vein implantation through chest wall.The data of the three groups had significant difference in the success rate of one puncture tube insertion,the success rate of one puncture more than one time,and the success rate of one-time tube delivery(P<0.05).However,there was no significant difference in the success rate of delivering tube more than once in the three groups(P>0.05).The incidence of complications in PICC,internal jugular CVC and axillary vein catheterization was 0.6%(3 cases),0.4%(4 cases)and 5.3%(11 cases),respectively.Conclusion The successful rate of puncture and transcatheter delivery of axillary vein in chest wall guided by ultrasound was higher,which has little difference with PICC and internal jugular vein CVC.It was suitable to be carried out in patients with tumor with individual demand and vascular condition.However,the accuracy of puncture technique and the prevention of complications should be paid more attention to ensure the safety of catheterization.

关 键 词：B超仪 腋静脉 PICC 颈内静脉 中心静脉置管术 

分 类 号：R730.5[医药卫生—肿瘤]