CT观察儿童外周中心静脉导管头端最佳位置  

The best position of the head end of peripherally inserted central venous catheter in children:CT study

作　　者：韦捷 周怡睿 王龙伦 蔡金华[1] WEI Jie;ZHOU Yirui;WANG Longlun;CAI Jinhua(Department of Radiology,Children's Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院放射科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,重庆400014

出　　处：《中国医学影像技术》2022年第7期1000-1003,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的以CT观察儿童外周中心静脉导管(PICC)头端最佳位置。方法回顾性分析246例接受胸部增强CT检查患儿,于胸部增强CT图像中测量上腔静脉(SVC)长度、气管隆嵴至上腔静脉-右心房交界处(CAJ)的距离(气管隆嵴-CAJ)及其对应椎体单元(VBU)数量;分析不同年龄段及不同性别患儿之间上述参数的差异,观察年龄与上述参数的相关性,寻找PICC头端最佳位置。结果246例患儿气管隆嵴均位于SVC上、下端之间。SVC长度、气管隆嵴-CAJ及对应VBU的男、女性差异均无统计学意义(P均>0.05),而不同年龄段之间上述参数差异均有统计学意义(P均<0.05)。患儿年龄与SVC长度及气管隆嵴-CAJ均高度正相关(r=0.921、0.800,P均<0.01),而与气管隆嵴-CAJ对应VBU无明显相关(r=0.018,P=0.781)。气管隆嵴至SVC下1/3上端距离为(8.62±4.88)mm,至SVC下1/3下端距离(即气管隆嵴-CAJ)为(21.14±8.51)mm。结论儿童PICC头端在SVC内的最佳位置为气管隆嵴水平下(8.62±4.88)~(21.14±8.51)mm,需结合年龄进行选择。Objective To observe the best position of the head end of peripherally inserted central venous catheter(PICC)in children with CT.Methods Data of 246 children who underwent enhanced chest CT were retrospectively analyzed.The length of the superior vena cava(SVC),the distance from tracheal carina to cavoatrial junction(tracheal carina-CAJ)and the corresponding vertebral body units(VBU)were measured on enhanced chest CT images.The above parameters were compared among children with different ages and genders,and the correlations of age and the above parameters were analyzed in order to explore the best position of the head end of PICC.Results The tracheal carina located between the upper and lower end of SVC in all 246 children.There was no significant difference of SVC length,tracheal carina-CAJ nor corresponding VBU between male and female children(all P>0.05),while there were significant differences of the above parameters among children with different ages(all P<0.05).The age of children was highly positively correlated with SVC length and tracheal carina-CAJ(r=0.921,0.800;both P<0.01),but not significantly correlated with tracheal carina-CAJ corresponding VBU(r=0.018,P=0.781).The distance from tracheal carina to the upper end of the lower 1/3 of SVC was(8.62±4.88)mm,while to the lower end of the lower 1/3 of SVC,namely tracheal carina-CAJ,was(21.14±8.51)mm.Conclusion The best position of the head end of PICC in children was(8.62±4.88)—(21.14±8.51)mm below the tracheal carina level in SVC,which needed to be judged combining with age.

关 键 词：儿童 腔静脉 上 导管插入术 中心静脉 体层摄影术 X线计算机 

分 类 号：R725[医药卫生—儿科] R445.3[医药卫生—临床医学]