超声引导下改良塞丁格结合钝性分离送鞘技术在PICC中的应用效果  

Application Effect of Modified Seldinger Combined with Blunt Separation and Sheath Delivery Technique under Ultrasound Guidance in PICC

作　　者：徐鑫星[1] 白茹[1] 宋迪[1] 史婷婷 XU Xinxing;BAI Ru;SONG Di;SHI Tingting(The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China;不详)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233004

出　　处：《中外医学研究》2021年第28期96-99,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：蚌埠一附院科技发展基金项目(BYKF1858)。

摘　　要：目的:探究在经外周中心静脉置管(PICC)中,采用超声引导下改良塞丁格结合钝性分离送鞘技术的应用效果。方法:本研究共300例研究对象,均为2018年12月-2019年11月本院住院治疗需植入PICC的患者,根据随机数字表法进行分组,150例采用超声引导下改良塞丁格结合钝性分离送鞘技术为试验组,另150例采用超声引导下改良塞丁格结合手术刀扩皮送鞘法为对照组。比较两组一次性送鞘成功率、置管换药情况与压迫止血例数。结果:试验组和对照组的一次性送鞘成功率分别为93.33%、91.33%,两组比较差异无统计学意义(χ^(2)=0.424,P>0.05)。在置管后局部渗液发生率上,试验组(1.33%)明显低于对照组(8.67%),差异有统计学意义(χ^(2)=8.491,P<0.05)。在24、72 h换药率及48 h压迫止血率上,试验组(7.33%、1.33%、2.67%)明显低于对照组(28.67%、12.00%、18.67%),差异有统计学意义(χ^(2)=166.32、235.714、205.618,P<0.05)。48 h渗血纱布层数上,试验组(4.37±1.31)层明显少于对照组的(6.87±1.42)层,差异有统计学意义(t=15.848,P<0.05)。结论:在PICC置管中,采用超声引导下改良塞丁格结合钝性分离送鞘技术的效果好,有利于改善置管后局部渗血情况,减少换药次数,降低局部渗液率,应用价值高,值得推广。Objective:To explore the application effect of improved Seldinger combined with blunt separation and sheath delivery technique under ultrasound guidance in the catheter placement through peripherally inserted central venous catheter(PICC).Method:A total of 300 subjects were selected in this study,all of them were hospitalized in our hospital from December 2018 to November 2019 and required PICC implantation,they were grouped according to the random number table.One hundred and fifty patients who used ultrasound-guided modified Seldinger combined with blunt separation and sheath delivery technique were the experimental group,and the other 150 cases were treated with modified Seidinger combined with scalpel under ultrasound guidance were the control group.Compared the success rate of one-time delivery of the sheath,dressing change and the cases of compression hemostasis.Result:The success rate of one-time delivery of the sheath in the experimental group was 93.33% and the control group was 91.33%,there was no significant difference between the two groups(χ^(2)=0.424,P>0.05).The incidence of local exudation in the experimental group(1.33%)was significantly lower than that in the control group(8.67%),and the difference was statistically significant(χ^(2)=8.491,P<0.05).In terms of 24,72 h dressing rate and 48 h compression hemostatic rate,the indexes in experimental group(7.33%,1.33%,2.67%)were significantly lower than the control group(28.67%,18.67%,12.00%),the differences were statistically significant(χ^(2)=166.321,235.714,205.618,P<0.05).The number of the blood oozing gauze layer within 48 h after the catheterization,the experimental group[(4.37±1.31)pieces]was significantly less than(6.87±1.42)pieces of the control group,the difference was statistically significant(t=15.848,P<0.05).Conclusion:In PICC catheter placement,the ultrasound-guided modified Seldinger combined with blunt separation and sheath delivery technology is effective.It is helpful to improve the condition of the local bleeding after catheter

关 键 词：PICC 置管 超声引导 改良塞丁格技术 钝性分离送鞘技术 应用效果 

分 类 号：R472[医药卫生—护理学]