两种体位在超声引导下ZIM区域行PICC置管的应用效果  

Application effect of PICC tube placement in ZIM area under ultrasound guidance in two positions

作　　者：王蒙蒙 李平[1] 贾灵芝[1] WANG Mengmeng;LI Ping;JIA Lingzhi(Binzhou Medical University Hospital,Binzhou 256603,Shandong,P.R.China)

机构地区：[1]滨州医学院附属医院,山东滨州256603

出　　处：《滨州医学院学报》2021年第2期141-144,共4页Journal of Binzhou Medical University

摘　　要：目的探讨两种体位在超声引导下最佳穿刺区域(ZIM)行PICC置管的应用效果,寻找适合在ZIM区域穿刺的最佳体位。方法将某院2018年6月—2019年11月80例确诊为血液病需PICC置管患者按照住院号随机分为对照组和观察组,所有患者全部行ZIM。对照组采用常规置管侧肢体外展与躯干呈90°体位进行穿刺,导管到达肩部时嘱患者头转向穿刺侧,下颌靠近肩部,将导管送至需要长度;观察组采用置管侧肢体举臂抱头体位进行穿刺,导管到达肩部时无需转头直接将导管送至需要长度。比较两组患者的舒适度、颈内静脉异位及置管成功率。结果在超声引导下PICC行ZIM区域穿刺法置管时,对照组疼痛程度得分为(8.425±0.808)明显高于观察组(7.825±1.111),P<0.05;对照组体位不适分值为(7.288±0.996)明显高于观察组(4.2±1.072),P<0.05。观察组颈内静脉异位发生率为2.50%(2/80)明显低于对照组的12.5%(10/80),P<0.05。对照组一次性穿刺置管成功率为90%,观察组一次性穿刺置管成功率为87.5%,差异没有统计学意义。结论举臂抱头体位是在超声引导下ZIM区域行PICC置管时的理想穿刺体位。Objective To explore the application effects of PICC catheterization in the ZIM area under ultrasound guidance in two positions,and to seek the best position suitable for puncture in the ZIM area.Methods From June 2018 to November 2019,80 patients with PICC intubation diagnosed with hematological diseases were randomly divided into the control group and the observation group according to the hospitalization number.All patients underwent the ZIM best area method as the best puncture point.In the control group,the conventional catheterization of the lateral extremity and the trunk at 90 degrees were used for puncture.When the catheter reached the shoulder,the patient's head was instructed to turn to the puncture side,and the lower jaw was close to the shoulder.The observation group used the position of the catheterized limb to lift the arm and hold the head for puncture.When the catheter reached the shoulder,the catheter was sent to the required length without turning the head.The comfort,internal jugular vein ectopic,and success rate of the catheter were compared between the two groups.Results When the PICC was placed by PICC under the guidance of ultrasound,the pain score in the control group(8.425±0.808)was significantly higher than that in the observation group(7.825±1.111),and the position discomfort score(7.288±0.996)in the control group was significantly higher.In the observation group(4.2±1.072),the difference was statistically significant(P<0.05).The incidence of internal jugular vein ectopic was 2.50%(2/80),significantly lower than thta in the control 12.5%(10/80).The difference was statistically significant,with P<0.05.The success rate of one-time puncture and catheterization was 90%in the control group and 87.5%in the observation group,and the difference was not statistically significant.Conclusion Raising the arm and holding the head is the ideal puncture position for PICC catheterization in the ZIM area under ultrasound guidance.

关 键 词：抱头体位 经外周静脉穿刺中心静脉置管 最佳穿刺区域 舒适度 颈内静脉异位 置管 

分 类 号：R472[医药卫生—护理学]