通过新型体外血管通路模型探索不同注射器用于PICC管封管预期效果的优选方案  

Exploring the Optimal Solution of Different Syringes for Expected Effects of PICC Tube Sealing by A Novel Vascular Access Model in Vitro

作　　者：李燕娥[1] 杨晓燕 吕敏敏 庄秦月 李华[1] 林恩宇 梁瀚文 练敏 钟瑞容 郑诗凤 LI Yan-e;YANG Xiao-yan;LV Min-min;ZHUANG Qin-yue;LI Hua;LIN En-yu;LIANG Han-wen;LIAN Min;ZHONG Rui-rong;ZHENG Shi-feng(Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Sciences,Guangdong Guangzhou 510080;Jinan University-University of Birmingham Joint Institute,Guangdong Guangzhou 510632)

机构地区：[1]广东省人民医院广东省医学科学院,广东广州510080 [2]暨南大学伯明翰学院,广东广州510632

出　　处：《中国医疗器械信息》2022年第11期41-44,174,共5页China Medical Device Information

基　　金：广东省医学科研基金项目(项目编号:A2022153);广东省人民医院“登峰计划”科研专项(项目编号:DFJH2020006)。

摘　　要：目的:通过新型体外血管通路模型探讨持续注射与脉冲注射对由PICC管组成的血管通路装置压力影响的差异,为临床实践中选择合适的注射方式进行PICC冲、封管方式提供依据。方法:建立两端连接有心电监护仪的体外血管通路测压模型,在压力传感器1端分别使用抽吸有2mL,5mL,10mL,10mL生理盐水的2mL,5mL,10mL,20mL注射器进行脉冲注射与持续注射。观察PICC管是否出现异常变形、破裂,通过心电监护仪采集每次注射时的输入端最高压、输入端最低压、输入端平均压、输出端平均压等数据。结果:各组PICC管均无发生变形、破裂等异常。各种型号注射器脉冲推注时输入端最高压显著高于持续推注,输入端最低压显著低于持续推注,且脉冲注射时20mL注射器输入端最高压较其他型号注射器低,2mL注射器输入端最低压可出现负值(-2.00mmHg),另外,脉冲注射时20mL注射器输入端最高压最低(240.00mmHg,均值180.50mmHg),5mL注射器与10mL注射器之间注射压力无显著差异;持续注射的输入端平均压较高,使用2mL注射器脉冲时输入端平均压低于持续注射,20mL注射器脉冲时压力高于持续注射;输出端平均压在使用各种型号注射器时均无明显差异。持续注射时上述所有压力均随着注射器型号的增大而上升。结论:2mL注射器用于脉冲注射存在血液回流风险;5mL注射器与10mL注射器压力相似,可以用于冲封管;20mL注射器推注费力,不适用于脉冲注射。Objective:A new in vitro vascular access model was used to explore the differences in the effects of continuous injection and pulse injection on the pressure of vascular access devices consisting of PICC tubes,providing a basis for selecting the appropriate injection method for PICC tube flushing and sealing in clinical practice.Methods:An extracorporeal vascular access manometry model with cardiac monitors connected at both ends was established,and 2mL/5mL/10mL/20mL syringes with 2mL/5mL/10mL saline inside were used for continuous injection and pulse injection at end 1 of the pressure sensor,respectively.The PICC tubes were observed for abnormal deformation and rupture,and the data of the highest pressure at the input end,the lowest pressure at the input end,the average pressure at the input end and the average pressure at the output end during each injection were collected by the cardiac monitor.Results:No abnormalities such as deformation and rupture occurred in PICC tubes in each group.The highest input pressure of all types of syringes during pulse injection was significantly higher than that during continuous injection,and the lowest pressure at the input was significantly lower than that during continuous injection.The highest pressure at the input of the 20mL syringe was lower than that of the other syringe types during pulse injection,and the lowest pressure at the input of the 2mL syringe could be negative(-2.00 mmHg).Moreover,the highest pressure at the input of the 20mL syringe was the lowest during pulse injection(240.00 mmHg;mean:180.50 mmHg),and there was no significant difference in injection pressure between the 5mL and 10mL syringe.The mean pressure at the input of the continuous injection was higher.The mean input pressure was lower with pulse injection using 2mL syringes and higher using 20mL syringes than with continuous injection.All of the above pressures increased with increasing syringe type during continuous injection.Conclusion:2mL syringes are used for pulse injection with the risk of

关 键 词：PICC 血管通路 脉冲注射 持续注射 注射器 压力 

分 类 号：TH789[机械工程—仪器科学与技术]