3种PICC置管技术在血液内科的应用探讨  

Application of three kinds of PICC catheterization techniques in blood medicine

作　　者：黄荣玉 文娇[1] 周红 莫嘉茹 Huang Rongyu;Wen Jiao;Zhou Hong;Mo Jiaru(Department of Hematology,Guangdong Second People's Hospital,Guangzhou,Guangdong,510317,China)

机构地区：[1]广东省第二人民医院血液科

出　　处：《当代医学》2020年第4期44-46,共3页Contemporary Medicine

摘　　要：目的探讨3种PICC置管技术在血液内科中的应用情况。方法选取本院2017年1月至2018年7月收治的120例行PICC置管术患者,根据置管患者的血管情况及置管技术方法分为3组,A组应用普通置管技术穿刺(40例),B组应用改良式塞丁格技术穿刺(40例),C组应用超声引导下的改良式塞丁格技术置管(40例)。比较3种置管方法临床应用效果。结果A组静脉炎发生率为52.5%,B组为50.0%,C组为40.0%,C组静脉炎发生率明显低于A组和B组(X^2=6.581,P<0.05);C组舒适度为87.5%,A组为15.0%,B组为15.0%,C组舒适度明显高于A组和B组(X^2=5.624,P<0.05);A组导管异位率为10.0%,B组为10.0%,C组为5.0%,C组导管异位率明显低于A组和B组(P<0.05);A组置管成功率为90.0%,B组为90.0%,C组为95.0%,C组置管成功率明显高于A组和B组患者(X^2=5.637,P<0.05)。结论3种PICC置管技术各有利弊,改良式塞丁格技术与普通置管技术所带来的舒适感较低,而超声引导下的改良式塞丁格技术置管不仅舒适度较高,而且患者还不易发生静脉炎,在临床上,可以根据患者的血管情况及医院的条件选择合适的置管技术,为恶性血液患者的长期治疗提供安全的输液途径。Objective To investigate the application of three PICC catheterization techniques in blood medicine.Methods 120 patients with PICC catheterization were enrolled in our hospital from January 2017 to July 2018.According to the vascular condition of the catheterized patients and the technique of catheterization,the patients were divided into three groups.Group A was treated with common catheter technique(40 cases).For example,group B was treated with modified seding technique(40 cases),and group C was treated with modified Södinger technique under ultrasound guidance(40 cases).Compared the clinical application effects of three kinds of catheterization methods.Results The incidence of phlebitis in group A was 52.5%,50.0%in group B and 47.5%in group C.The incidence of phlebitis in group C was significantly lower than that in group A and group B(X^2=6.581,P<0.05).The comfort in group Cwas 87.5%,15.0%in group A and 15.0%in group B.The comfort of group C was significantly higher than that of group A and group B(X^2=5.624,P<0.05);The rate of catheter ectopic in group A was 10.0%,the group B was 10.0%,and the group C was 5.0%.The ectopic rate of the group C was significantly lower than that of the group A and the group B(P<0.05).The success rate of tube placement in group A was 90.0%,and that in group B was 90.0%,Group C was 95.0%,the success rate of group C was significantly higher than that of group A and group B(X^2=5.637,P<0.05).Conclusion The three types of PICC catheterization techniques have their own advantages and disadvantages.The improved Sedinger technology and the common tube placement technology bring less comfort,while the improved Sedinger technique under ultrasound guidance not only has a high degree of comfort.And patients are not prone to phlebitis.In clinical practice,appropriate catheterization techniques can be selected according to the patient's vascular condition and hospital conditions to provide a safe infusion route for longterm treatment of patients with malignant blood.

关 键 词：PICC置管技术 血液内科 改良式塞丁格技术 超声引导 应用 

分 类 号：R472[医药卫生—护理学]