超声引导下平面内进针法用于老年肿瘤患者经外周静脉置入中心静脉导管的效果  

The effect of ultrasound-guided in-plane needle insertion in elderly tumor patients with central venous catheter placement through peripheral veins

作　　者：杨燕[1] 钱菊云 方秀花[3] 钱爱新[4] 吴立新[1] 陈晓红[5] Yang Yan;Qian Juyun;Fang Xiuhua;Qian Aixin;Wu Lixin;Chen Xiaohong(Nursing Department,Anqing Municipal Hospital,Anqing 246003,China;不详)

机构地区：[1]安庆市立医院护理部,安庆246003 [2]安庆市立医院血液内科,安庆246003 [3]安庆市立医院重症医学科,安庆246003 [4]安庆市立医院肿瘤内科,安庆246003 [5]安庆市立医院甲状腺乳腺外科,安庆246003

出　　处：《中国临床保健杂志》2022年第2期263-265,共3页Chinese Journal of Clinical Healthcare

基　　金：安徽省教育厅2019年度高校优秀青年人才支持计划项目(gxyqZD2019039);安徽医科大学2019年度临床科学基金项目(2019xkj238)。

摘　　要：目的探讨超声引导下平面内进针法行老年恶性肿瘤患者经外周静脉置入中心静脉导管(PICC)的临床实践效果。方法收集2019年9月至2021年11月某三甲医院老年恶性肿瘤患者71例,按照会诊置管时间分为对照组与观察组。对照组35例,实施超声引导下平面外进针法置管;观察组36例,实施超声引导下平面内进针法置管。采用卡方检验、Fisher精确概率法、t检验,比较两种方法操作时间、穿刺次数、一次性置管成功率、及置管并发症(穿刺点渗血渗液、穿刺点感染、机械性静脉炎、导管异位)情况。结果观察组穿刺次数及操作时间均少于对照组,一次性置管成功率高于对照组(P<0.05),置管成功后比较2组穿刺点渗血渗液、机械性静脉炎、穿刺点感染发生率等,观察组低于对照组(P<0.05)。结论采用超声引导下平面内进针技术置管,可明显减少穿刺次数,提高老年恶性肿瘤患者PICC置管的一次性置管成功率,降低并发症发生。Objective To investigate the clinical effect of ultrasound-guided in-plane needle insertion in PICC catheter placement in elderly patients with malignant tumors.Methods A total of 71 elderly patients with malignant tumors in a tertiary hospital from September 2019 to November 2021 were collected,and divided into control group and observation group according to the time of consultation and catheterization.In the control group,35 cases were placed under the ultrasound-guided out-of-plane needle insertion method;36 cases in the observation group were treated with the ultrasound-guided in-plane needle insertion method.Chi-square test,Fisher′s exact test,and t test were used to compare the operation time,the number of punctures,the success rate of one-time cannulation,and the complications of cannulation(blood and exudate from the puncture site,infection of the puncture site,mechanical veins,etc.)inflammation,ectopic catheter).Results The number of punctures and operation time in the observation group were less than those in the control group,and the success rate of one-time catheter placement was higher than that in the control group(P<0.05).After successful catheterization,the incidences of blood and exudate from the puncture site,infection of the puncture site,mechanical veins were compared between the two groups,and the observation group was lower than the control group(P<0.05).Conclusions The use of ultrasound-guided in-plane needle insertion technique can significantly reduce the times of punctures,improve the one-time success rate of PICC catheterization in elderly patients with malignant tumors,reduce the incidence of complications.

关 键 词：肿瘤 导管插入术 中心静脉 超声检查 介入性 手术后并发症 老年人 

分 类 号：R47[医药卫生—护理学]