超声引导穿刺联合腔内心电图定位在成年肿瘤PICC置管患者中的应用  

Clinical application of ultrasound-guided puncture combined with intracavitary electrocardiogram in PICC implantation positioning in adult cancer patients

作　　者：兰恒平 朱乾云 吕玲 刘丹丹[1] 李艳[1] 朱振华 LAN Hengping;ZHU Qianyun;LV Ling;LIU Dandan;LI Yan;ZHU Zhenhua(Department of Hematology,Affiliated Fuyang People's Hospital,Anhui Medical University,Fuyang,Anhui Province 236000,China)

机构地区：[1]安徽医科大学附属阜阳人民医院血液科,安徽阜阳236000

出　　处：《介入放射学杂志》2023年第4期389-393,共5页Journal of Interventional Radiology

摘　　要：目的 探讨超声引导穿刺联合腔内心电图(intracavitary electrocardiogram, IECG)定位技术应用于PICC置管患者的可行性及安全性。方法 以2019年6月至2021年8月安徽医科大学附属阜阳人民医院行B超引导穿刺联合腔内心电图定位的PICC置管患者127例作为观察组,2017年1月至2019年5月行超声引导穿刺的PICC置管患者115例作为对照组。比较两组患者PICC导管头端处于正确位置的首次成功率、置管2周内相关并发症的发生率、180 d内PICC导管累积技术生存率。结果 观察组PICC导管头端处于正确位置的首次成功率为96.85%,对照组为60.00%,差异有统计学意义(P<0.01)。观察组PICC置管术后2周并发症的发生率为12.60%,对照组为24.35%,差异有统计学意义(P=0.018)。观察组180 d内PICC导管累积技术生存率达到90.4%,对照组为80.6%,差异有统计学意义(P<0.05)。结论 在成年肿瘤PICC置管患者中,经B超引导穿刺联合IECG定位技术操作简单,可提高置管的导管头端处于正确位置首次成功率,降低PICC置管并发症的风险,且180 d累积技术生存率提高。Objective To investigate the feasibility and safety of ultrasound-guided puncture combined with intracavitary electrocardiogram (IECG) in peripherally inserted central venous catheter (PICC)implantation positioning in adult cancer patients.Methods A total of 127 patients,who received PICC implantation with ultrasound-guided puncture combined with IECG positioning technique between June 2019and August 2021 at the Affiliated Fuyang People's Hospital of Anhui Medical University of China,were collected as the observation group,and other 115 patients,who received ultrasound-guided puncture PICC implantation between January 2017 and May 2019,were collected as the control group.The initial success rate of the PICC catheter tip being inserted in the correct position,the incidence of related complications occurring within 2 weeks after implantation,and the cumulative technical survival of the PICC catheter within180 days after implantation were compared between the two groups.Results The initial success rate of the PICC catheter tip being inserted in the correct position in the observation group was 96.85%,which in the control group was 60.00%,the difference between the two groups was statistically significant(P<0.01).The incidence of complications in 2 weeks after PICC implantation in the observation group was 12.60%,which was 24.35%in the control group,the difference between the two groups was statistically significant (P=0.018).The cumulative technical survival of the PICC catheter within 180 days in the observation group was up to 90.4%,which in the control group was 80.6%,the difference between the two groups was statistically significant(P<0.05).Conclusion For performing PICC implantation in adult cancer patients,ultrasound-guided puncture combined with IECG positioning technique is simple to operate,it can improve the initial success rate of the PICC catheter tip being inserted in the correct position,reduce the risk of complications caused by PICC implantation,and improve the cumulative technical survival of the P

关 键 词：经外周置入中心静脉导管 腔内心电图 超声引导 

分 类 号：R473.73[医药卫生—护理学]