超声引导下改良塞丁格技术在肘上PICC置管应用分析  

Analysis of the application of ultrasound-guided modified Seidinger technique in the placement of PICC catheters on the elbow

作　　者：邓蓉 黄改霞 李倩[2] 肖粉 陈艳芳 石丽 冉素 DENG Rong;HUANG Gaixia;LI Qian;XIAO Fen;CHEN Yanfang;SHI Li;RAN Su(Department of Critical Care Medicine,Shandong Provincial Hospital Heze Hospital(Heze Municipal Hospital),Heze 274000,China;Department of Neurology Intensive Care,Shandong Provincial Hospital Heze Hospital(Heze Municipal Hospital),Heze 274000,China;Department of Ultrasound,Shandong Provincial Hospital Heze Hospital(Heze Municipal Hospital),Heze 274000,China)

机构地区：[1]山东省立医院菏泽医院(菏泽市立医院)重症医学科,山东菏泽274000 [2]山东省立医院菏泽医院(菏泽市立医院)神经重症科,山东菏泽274000 [3]山东省立医院菏泽医院(菏泽市立医院)超声科,山东菏泽274000

出　　处：《医学影像学杂志》2024年第4期96-98,共3页Journal of Medical Imaging

摘　　要：目的 探讨超声引导下改良塞丁格技术在肘上经外周静脉穿刺中心置管(PICC)应用价值分析。方法 选取340例接受超声引导下改良塞丁格技术行肘上PICC置管患者,按照穿刺部位分为贵要静脉组204例、肱静脉组82例、头静脉组54例,对三组穿刺成功率及并发症发生情况进行分析。结果 贵要静脉组置管成功率96.08%,高于肱静脉组95.12%、头静脉组87.04%,异位导管率3.92%,低于肱静脉组4.88%、头静脉组12.96%,差异有统计学意义(P<0.05);贵要静脉组并发症率3.43%,低于肱静脉组3.66%,头静脉组12.96%,差异有统计学意义(P<0.05);贵要静脉组穿刺次数、置管时间低于肱静脉组、头静脉组,差异有统计学意义(P<0.05)。结论 超声引导下改良塞丁格技术经肘上PICC置管后成效显著,对于无法将贵要静脉作为穿刺静脉者,可选择肱静脉、头静脉为备选。Objective To explore the impact of different puncture sites on the complications of ultrasound-guided modified Seedinger technique for upper elbow peripheral venous puncture central catheterization(PICC)placement.Methods We selected 340 patients who underwent ultrasound-guided modified Seidinger technique for upper elbow PICC catheterization in our hospital from May 2022 to December 2023.Among them,204 patients were selected from the Guiyao vein,82 patients from the brachial vein,and 54 patients from the cephalic vein.We analyzed the success rate of puncture and the incidence of complications in the three groups of patients.Results The success rate of catheterization in the Guiyao vein group was 96.08%,which was higher than 95.12%in the brachial vein group and 87.04%in the cephalic vein group.The ectopic catheterization rate was 3.92%,which was lower than 4.88%in the brachial vein group and 12.96%in the cephalic vein group,with P<0.05;The incidence of complications in the Guiyao venous group was 3.43%,lower than that in the humeral venous group at 3.66%and the cephalic venous group at 12.96%,with P<0.05;The number of punctures and catheterization time in the Guiyao venous group were lower than those in the brachial and cephalic venous groups,with P<0.05.Conclusion The improved Seedinger technique guided by ultrasound has shown significant results after PICC catheterization on the elbow,with a high success rate of puncture.For those who cannot use the precious vein as the puncture vein,the brachial vein can be chosen as the alternative vein for PICC catheterization.The success rate and complication rate of cephalic vein puncture are low,and vascular puncture should be selected reasonably based on the patient's situation.

关 键 词：肱静脉 贵要静脉 头静脉 超声检查 外周静脉穿刺中心置管 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.6[医药卫生—诊断学]