CT定位上腔静脉用于PICC置管中的价值分析  

Value Analysis of CT Positioning Superior Vena Cava in PICC Catheterization

作　　者：王承光[1] 张鹏 冉慕光[1] 陈圣欢 雷俊杰[1] 邓树芳 WANG Cheng-guang;ZHANG Peng;RAN Mu-guang;CHEN Sheng-huan;LEI Jun-jie;DENG Shu-fang(Department of Radiology,The Sixth Affiliated Hospital of Guangzhou Medical University(Qingyuan People's Hospital,Guangdong Province),Qingyuan,Guangdong Province,511500 China)

机构地区：[1]广州医科大学附属第六医院(广东省清远市人民医院)放射科,广东清远511500

出　　处：《世界复合医学》2020年第7期122-124,共3页World Journal of Complex Medicine

基　　金：清远市科技计划项目(2018B014)。

摘　　要：目的探讨CT定位上腔静脉用于经外周静脉穿刺置入中心导管(PICC)中的价值。方法选取2016年6月—2018年12月收治的PICC患者100例作为研究对象,所有患者均进行胸部CT增强检查,测量患者气管隆突到上腔静脉下端的距离及对应胸椎单元数目,并对上腔静脉下1/3段在气管隆突下所处位置进行计算,以该段位置作为PICC尖端理想位置,通过CT定位图评价患者置管情况。结果上腔静脉下1/3段的下端位于气管隆突下(48.41±6.52)mm,对应(2.06±0.34)个胸椎单元;上腔静脉下1/3段的上端位于气管隆突下(21.36±5.82)mm,对应(0.89±0.28)个胸椎单元。在CT定位图上判断PICC尖端是否在理想位置时,相较于以气管隆突下21.5~48.5 mm作为参考标准,以气管隆突下0.9~2.1个胸椎单元作为上腔静脉下1/3段的参考标准具有更高的准确性,差异有统计学意义(P<0.05)。结论在判断PICC尖端是否位于上腔静脉下1/3段时,可以用气管隆突下0.9~2.1个胸椎单元作为参考标准。Objective To explore the value of CT positioning of the superior vena cava for the placement of a central catheter(PICC)via peripheral venipuncture.Methods 100 patients with PICC admitted from June 2016 to December 2018 were selected as the research object.All patients underwent chest CT enhancement examination.The distance between the trachea protuberance to the lower end of the superior vena cava and the number of corresponding thoracic vertebral units were measured.The position of the lower 1/3 segment of the superior vena cava under the tracheal carina was calculated,and the position of this segment was used as the ideal position of the PICC tip.The CT positioning map was used to evaluate the patient's catheterization.Results The lower end of the upper 1/3 segment of the superior vena cava was located below the tracheal carina(48.41±6.52)mm,corresponding to(2.06±0.34)thoracic vertebral units;the upper end of the lower 1/3 segment of the superior vena cava was located below the trachea embolus(21.36±5.82)mm,corresponding to(0.89±0.28)thoracic vertebra units.When judging whether the tip of the PICC is in the ideal position on the CT positioning map,compared with the reference standard of 21.5-48.5 mm under the trachea protuberance,0.9-2.1 thoracic vertebral units under the trachea protuberance are used as the lower 1/3 segment of the superior vena cava,the reference standard has higher accuracy,the difference was statistically significant(P<0.05).Conclusion When judging whether the tip of PICC is located in the lower third of the superior vena cava,0.9-2.1 thoracic vertebral units under the tracheal carina may be used as a reference standard.

关 键 词：CT 上腔静脉 经外周静脉穿刺置入中心导管 

分 类 号：R446.8[医药卫生—诊断学] R816.2[医药卫生—临床医学]