1例双上腔静脉患者Sherlock 3CG尖端定位下经外周静脉穿刺中心静脉置管及护理对策  

Sherlock 3CGtip confirmation system for placement of peripherally inserted central catheters and related nursing countermeasures in a patient with double superior vena cava

作　　者：宋兰娜 王媛 王文萱 王钰 张娜 SONG Lanna;WANG Yuan;WANG Wenxuan;WANG Yu;ZHANG Na(Department of Surgery,Hematology Hospital Chinese Academy of Medical Sciences and Peking Union Medical College,Institute of Hematology and Blood Diseases Hospital and Peking Union Medical College,Chinese Academy of Medical Sciences,State Key Laboratory of Experimental Hematology,National Clinical Research Center for Blood Diseases,Haihe Laboratory of Cell Ecosystem,Tianjin 300020;Tianjin Institutes of Health Science,Tianjin,301600)

机构地区：[1]中国医学科学院血液病医院中国医学科学院血液学研究所实验血液学国家重点实验室国家血液系统疾病临床医学研究中心细胞生态海河实验室手术室,天津300020 [2]天津医学健康研究院,天津301600

出　　处：《中西医结合护理》2023年第7期195-200,共6页Chinese Journal of Integrative Nursing

摘　　要：本文总结了应用Sherlock 3CG尖端定位技术为1例急性髓系白血病伴有双侧上腔静脉患者双侧置入经外周静脉穿刺中心静脉导管(PICC)的护理对策。本例患者为满足治疗需求分别于两次经两侧置入PICC导管,导管尖端分别位于右、左两侧上腔静脉。患者首次选择右侧上臂置管过程顺利,再次置管选择左侧置入过程顺利,应用Sherlock 3CG技术定位,导管送至预留长度范围P波持续呈负波,查看计算机断层扫描(CT)结果提示患者存在永存左上腔静脉,行X光定位确认导管尖端位于左侧上腔静脉。经多学科团队综合评估,调整导管留置长度,密切观察患者情况,加强多方面健康宣教,导管留置成功,无并发症发生。This paper summarized the experience of using Sherlock 3CG tip confirmation sys-tem for bilaterally placement of peripherally inserted central catheters(PICC)and related nursing countermeasures in a patient with double superior vena cava.In order to meet the treatment needs,PICC catheters were placed on both sides twice,with the catheter tips located in the right and left superior vena cava.The patient's first choice of the right upper arm for catheterization was smooth,and the second choice of the left side for catheterization was smooth.The Sherlock 3CG tip confirmation system was used for positioning.The P wave of the catheter sent to the reserved length continued to be negative.The results of computer tomography(CT)showed that the patient had permanent left superior vena cava.The X-ray positioning was performed to con-firm that the tip of the catheter was located in the left superior vena cava.After comprehensive evaluation by the multidisciplinary team,the catheter indwelling length was adjusted,The patient's condition was closely observed,and health education was strengthened in many aspects.In-dwelling catheter was successfully placement without complications.

关 键 词：双上腔静脉 永存左上腔静脉 Sherlock 3CG 经外周静脉穿刺中心静脉导管 

分 类 号：R473.6[医药卫生—护理学]