经外周静脉穿刺中心静脉置管术后导管头端定位点位置的选择及临床应用  

Selection of Catheter Tip Positioning location After Peripherally Inserted Central Catheterization and Clinical Application

作　　者：魏颖慧[1] Wei Yinghui(Department of Hematology,Peking University Shenzhen Hospital,Shenzhen 518000,Guangdong Province,China)

机构地区：[1]北京大学深圳医院血液内科,广东深圳518000

出　　处：《中国社区医师》2023年第29期119-121,共3页Chinese Community Doctors

摘　　要：目的:分析经外周静脉穿刺中心静脉置管(PICC)术后胸部X线上腔静脉入右心房口(CAJ)投影点位置的选择及临床应用。方法:选取2018年1月—2021年1月北京大学深圳医院血液内科收治的PICC术后患者100例作为研究对象。所有患者实施CT平扫,以CT定位相模拟X线平片,测量患者右侧第6、7肋间隙,右侧第6后肋、肺门角、右肺门中点、左肺门中点至CAJ的距离。结果:肺门角距离CAJ的位置最近,右侧第6后肋距离CAJ最远,在与肋骨相关的影像学解剖结构中,右侧第7后肋距离CAJ最近。各影像解剖结构至CAJ的距离比较,差异有统计学意义(P=0.001)。其中右侧第6、7肋间隙与左肺门中点,右侧第7后与右肺门中点比较,差异无统计学意义(P>0.05),其余各位置间两两比较,差异均有统计学意义(P<0.05)。结论:肺门角的位置距离CAJ较近,为CAJ最佳投影位置。Objective:To analyze the selection of superior vena cava into the right atrial orifice(CAJ)projection point position on postoperative chest X-ray plain film after peripherally inserted central catheterization(PICC).Methods:From January 2018 to January 2021,100 patients after PICC who were admitted to Department of Hematology,Peking University Shenzhen Hospital were selected as the study subjects.All patients received CT plain scan,and CT localization phase was used to simulate X-ray plain scan.The right 6th and 7th intercostal space,and the distance from the right 6th posterior rib,hilar angle,right hilar midpoint,and left hilar midpoint to CAJ were measured.Results:The distance between hilar angle and the CAJ position was the closest,and the distance between the right 6th posterior rib and the CAJ position was the farthest,in the imaging anatomy associated with the ribs,the right 7th posterior rib was closest to the CAJ.There was a statistically significant difference in the distance from the imaging anatomical structures to the CAJ(P=0.001).There was no significant difference between the right 6th and 7th intercostal space and the left hilar midpoint and between the right 7th posterior rib and the right hilar midpoint(P>0.05),while the differences between the other positions were statistically significant(P<0.05).Conclusion:The position of hilar angle is close to the CAJ,it is the best projection position of CAJ.

关 键 词：经外周静脉穿刺中心静脉置管 胸部X线 CAJ投影点 

分 类 号：R472[医药卫生—护理学]