经外周静脉穿刺中心静脉置入术导管异位的影响因素  

Related factors of peripherally inserted central catheter catheter displacement

作　　者：廖利萍[1] 王科[1] 陈英[1] 高英[1] 董荔[1] 彭娜 袁义芹 LIAO Li-ping;WANG Ke;CHEN Ying;GAO Ying;DONG Li;Peng Na;YUAN Yi-qin(Department of Neurosurgery,Chongqing Emergency Medical Center,Chongqing 400014,China;Department of Oncology,Army Medical Center of PLA,Chongqing 400042,China;Department of Critical Care Medicine,First Affiliated Hospital of Chongqing Medical College,Chongqing 400060,China)

机构地区：[1]重庆市急救医疗中心神经外科,重庆400014 [2]陆军特色医学中心肿瘤科,重庆400042 [3]重庆医药高等专科学校附属第一医院重症医学科,重庆400060

出　　处：《局解手术学杂志》2020年第3期231-234,共4页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的探讨经外周静脉穿刺中心静脉置入术(PICC)发生导管异位的相关因素,提出针对性的干预措施,以减少导管异位的发生。方法回顾性分析2016年1月至2018年12月在重庆市急救医疗中心神经外科行PICC的167例患者的临床资料,统计PICC导管异位情况,对可能引起导管路径异常的相关影响因素进行统计学分析。结果本组167例PICC患者中,导管异位16例(9.58%)。多因素logistic回归分析结果显示,气管切开(OR=1.569)、机械通气(OR=1.598)、经头静脉穿刺(OR=1.985)、患者意识障碍(OR=1.866)、送管次数大于2次(OR=1.265)、锁骨下静脉置管史(OR=1.632)是神经外科患者PICC导管异位的危险因素。结论神经外科有高危因素的患者行PICC置管时,建议首选经贵要静脉路径穿刺置管,肘正中静脉次之,同时应根据患者个体情况,给予针对性的干预措施,减少PICC导管异位发生率。Objective To investigate the related factors of the ectopy of peripherally inserted central catheter(PICC)in neurosurgery patients,and specific intervention measures were proposed to reduce the occurrence of catheter displacement.Methods The clinical data of 167 patients with PICC in neurosurgery department of Chongqing emergency medical center from January 2016 to December 2018 was retrospectively analyzed.The number of PICC catheter ectopic cases was counted,the possible related factors of PICC catheter displacement were statistically analyzed.Results There were 16 cases of catheter displacement(9.58%)in 167 patients with PICC.The results of multinomial logistic regression analysis showed that tracheotomy(OR=1.569),mechanical ventilation(OR=1.598),the cephalic veinpuncture(OR=1.985),consciousness disorder(OR=1.866),catheter delivery more than 2 times(OR=1.265),subclavian vein catheterization history(OR=1.632)were the risk factors of PICC catheter displacement.Conclusion For patients with high risk factors in neurosurgery department,PICC is suggested to be performed through the basilic vein firstly,followed by the medial cubital vein,meanwhile,specific intervention measures should be given according to individual circumstance to reduce the incidence of PICC catheter displacement.

关 键 词：经外周静脉穿刺中心静脉置入术 导管异位 肘正中静脉 贵要静脉 影响因素 

分 类 号：R543.4[医药卫生—心血管疾病]