钝性分离在儿童B超引导结合改良塞丁格PICC置管中的应用  

Application of blunt separation in B-ultrasound guidance combined with modified Sedinger technique in PICC catheterization for children

作　　者：范菊红[1] 谢珺[2] 宋娜[1] 吴菲菲 FAN Juhong;XIE Jun;SONG Na;WU Feifei(Department of Hematology,Wuxi Children's Hospital Affiliated to Nanjing Medical University,Wuxi Children's Hospital,Jiangsu,Wuxi 214000,China;Department of Nursing,Wuxi Children's Hospital Affiliated to Nanjing Medical University,Wuxi Children's Hospital,Jiangsu,Wuxi 214000,China)

机构地区：[1]南京医科大学附属无锡儿童医院,无锡市儿童医院血液科,江苏无锡214000 [2]南京医科大学附属无锡儿童医院,无锡市儿童医院护理部,江苏无锡214000

出　　处：《中国医药科学》2021年第18期84-87,共4页China Medicine And Pharmacy

基　　金：南京医科大学科技发展基金-一般项目(NMUB2018366)。

摘　　要：目的探讨钝性分离在儿童B超引导结合改良塞丁格经外周静脉穿刺中心静脉置管(PICC)中的应用研究。方法选取2019年1月1日至2020年12月30日在南京医科大学附属无锡儿童医院PICC置管患儿60例,均行B超引导结合改良塞丁格PICC置管,根据不同扩皮方式分为观察组及对照组,每组各30例,对照组行传统手术刀扩皮送鞘技术,观察组行钝性分离送鞘技术,对两组即刻出血量、置管24 h出血量、渗液发生率、一次性送鞘成功率、总送鞘时间、一周内维护次数进行比较。结果观察组即刻出血量、置管24 h出血量与对照组比较,差异有统计学意义(P<0.05);观察组置管后1、2、4、7 d渗液发生率分别为3.33%、3.33%、0.00%,0.00%,明显较对照组低,差异有统计学意义(P<0.05);观察组一次性送鞘成功率为93.33%,明显高于对照组的70.00%,观察组总送鞘时间、一周内维护次数均较对照组少,差异有统计学意义(P<0.05)。结论钝性分离在儿童B超引导结合改良塞丁格PICC置管中应用价值较高,可减少置管出血量,降低渗液发生率,还可提高一次性送鞘成功率,缩短送鞘时间,减少维护次数,值得推广应用。Objective To investigate the application of blunt separation in B-ultrasound guidance combined with modified Sedinger technique in peripherally inserted central catheter(PICC)catheterization for children.Methods A total of 60 children undergoing PICC catheterization from January 1,2019 to December 30,2020 in Wuxi Children's Hospital Affiliated to Nanjing Medical University were selected as study objects.All of them underwent B-ultrasound guidance combined with modified Sedinger technique in PICC catheterization.According to different skin expansion methods,they were divided into the observation group and the control group,with 30 cases in each group.The control group received traditional scalpel expansion and sheath delivery technique,while the observation group received blunt separation and sheath delivery technique.The immediate blood loss,blood loss at 24 hours after catheterization,incidence of exudate,success rate of one-time sheath delivery,total sheath delivery time,and maintenance frequency within a week were compared between the two groups.Results The immediate blood loss and the blood loss at 24 hours after catheterization in the observation group were significantly different from those in the control group(P<0.05).The incidences of exudate at 1,2,4 and 7 d after catheterization in the observation group(3.33%,3.33%,0.00%,0.00%)were significantly lower than those in the control group,with statistically significant differences(P<0.05).The success rate of one-time sheath delivery in the observation group(93.33%)was significantly higher than that in the control group(70.00%).The total sheath delivery time and maintenance frequency within a week in the observation group were less than those in the control group,with statistically significant differences(P<0.05).Conclusion Blunt separation is of high value in B-ultrasound guidance combined with modified Sedinger technique in PICC catheterization for children and can reduce blood loss during catheterization and the incidence of exudate,increase the success rat

关 键 词：钝性分离 儿童 B超引导 改良塞丁格 PICC置管 

分 类 号：R473.72[医药卫生—护理学]