一针式皮下隧道法结合Sherlock 3CG在PICC置管中的应用  

Application of the Sherlock 3CGtip Confirmation System Combined With One-insertion Subcutaneous Tunneling Technique in PICC Catheterization

作　　者：莫英蕾[1] 陈芸梅[2] 叶扬 李云 朱淑连 MO Yinglei;CHEN Yunmei;YE Yang;LI Yun;ZHU Shulian(Department of Venous Treatment,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou Guangdong 510080,China;Oral and Maxillofacial Surgery,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou Guangdong 510080,China)

机构地区：[1]中山大学附属第一医院静脉治疗专科,广东广州510080 [2]中山大学附属第一医院口腔颌面外科,广东广州510080

出　　处：《中国继续医学教育》2021年第30期187-191,共5页China Continuing Medical Education

摘　　要：目的探讨一针式皮下隧道法结合Sherlock 3CG尖端定位系统在PICC置管中的应用效果。方法选取2021年6—8月行上肢PICC置管的46例患者,按随机数字表法分为两组,对照组21例,观察组25例,对照组采用常规穿刺法结合Sherlock 3CG尖端定位系统,观察组采用一针式皮下隧道法结合Sherlock 3CG尖端定位系统进行PICC置管,并对置管效果进行分析。结果46例患者胸片结果显示:导管尖端均位于胸6~8椎体水平,导管尖端一次性到位率100%。观察组穿刺时间略长于对照组,但P>0.05,差异无统计学意义。观察组疼痛程度较对照组减轻,P<0.05,差异有统计学意义。移位、堵管、渗血、瘀斑等并发症发生率均低于对照组。结论一针式皮下隧道法置入PICC技术创伤小,并发症发生率低,置管过程中利用Sherlock 3CG尖端定位系统,可增加定位准确率,提高一次性置管成功率。两者结合是一种更为安全、有效的PICC置管方式。Objective To discuss the application effect of the Sherlock 3CGtip confirmation system combined with one-insertion subcutaneous tunneling technique in PICC catheterization.Methods Forty-six patients undergoing PICC catheterization in upper limbs from June 2021 to August 2021 were divided into two groups according to random digital table.Control group had 21 cases,and observation group had 25 cases.Control group used conventional puncture combined with the Sherlock 3CGtip confirmation system and observation group used one-insertion subcutaneous tunneling technique combined with the Sherlock 3CGtip confirmation system,and we analyzed the application effect.Results The results of chest radiograph showed that the catheter tip was at the level of C6-8 vertebrae,the one-time catheter tip arrival rate was 100%.The puncture time of observation group was slightly longer than the control groups’,but it was not statistically significant,because P>0.05.The observed group had reduced pain compared with the control group,and it was statistically significant,because P<0.05.The incidence of complications,such as displacement,tube blockage,congestion,and ecchymosis,were all lower than control groups’.Conclusion The one-insertion subcutaneous tunneling technique has less trauma and a low incidence of complications.The Sherlock 3CGtip confirmation system can increase the positioning accuracy and improve the success rate of one-time tube placement.The combination of the two methods is a safer and more effective new PICC tube placement method,with good clinical practicability and promotion value.

关 键 词：皮下隧道 Sherlock 3CG PICC 电磁导航 腔内心电图 尖端定位 

分 类 号：R543[医药卫生—心血管疾病]