改良腔内心电图定位技术在乳腺外科颈内静脉输液港中的应用  

Application of modified intracavitary electrocardiogram positioning technology in internal jugular vein infusion port of breast surgery

作　　者：邹岩[1] 孟春晖 李艳 徐梦丹 马慧[1] ZOU Yan;MENG Chunhui;LI Yan;XU Mengdan;MA Hui(Department of Breast and Thyroid Surgery,Shandong Heze Municipal Hospital,Heze,Shandong,274000,China)

机构地区：[1]山东菏泽市立医院乳腺甲状腺外科,山东菏泽274000

出　　处：《当代医学》2024年第7期144-147,共4页Contemporary Medicine

摘　　要：目的探讨改良腔内心电图定位技术应用于乳腺外科颈内静脉输液港的效果。方法选取2020年4月至2022年4月于菏泽市立医院乳腺中心行乳腺癌术后植入颈内静脉输液港的90例患者作为研究对象,按入院手术时间分为A组、B组与对照组,每组30例。A组采用金属导丝法,B组选取30例行盐水柱法,对照组采用传统体表测量计算植入长度。比较3组导管尖端位置正常、最佳及异位发生率,心脏事件发生率。结果A组和B组尖端位置正常率、最佳率、异位率比较差异无统计学意义;A组和B组尖端位置正常率、最佳率、异位率均高于对照组,差异有统计学意义(P<0.05)。3组心脏事件发生率比较差异无统计学意义。实际操作过程中,正常心电图波形和腔内心电图诱导出现的特异性P波;采用导线线径>2 mm时信号衰减明显,线径<1.5 mm的线材能在普通心电监护仪上诱导成功,其中效果最好的是PICC适用鳄鱼夹线。结论改良腔内心电图定位技术应用于颈内静脉输液港植入,可通过选用适宜的导线和溶液介质,在无需额外专业设备和专业人员的情况下完成术中导管定位,且不增加心脏事件的发生,具有较高安全性,值得临床广泛应用。Objective To explore the effect of modified intracavitary electrocardiogram positioning technology in internal jugular vein infusion port of breast surgery.Methods 90 patients who were implanted with an intra-jugular intravenous port after breast cancer surgery at the Breast Center of Shandong Heze Municipal Hospital from April 2020 to April 2022 were selected as the research subjects,and divided into the group A,the group B and the control group according to the time of admission to the hospital for surgery.The group A used the metal guidewire method,the group B used routine saline column method,and the control group used conventional body surface measurements to calculate the implant length.The incidence of normal,optimal and ectopic catheter tip position and the incidence of cardiac events were compared among the three groups.Results There was no significant difference in the normal rate,optimal rate and ectopic rate of tip position between the group A and the group B;the normal rate,optimal rate and ectopic rate of tip position in the group A and the group B were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of cardiac events among the three groups.During the actual operation,the normal electrocardiogram waveform and the specific P wave induced by the intracavitary electrocardiogram;when the wire diameter>2 mm,the signal attenuation is obvious,and the wire diameter<1.5 mm can be successfully induced on the ordinary electrocardiogram monitor.The best effect is that PICC is suitable for crocodile clip line.Conclusion The application of modified intracavitary electrocardiogram positioning technology in the implantation of internal jugular vein infusion port can complete the intraoperative catheter positioning without additional professional equipment and personnel by selecting appropriate wire and solution medium,and does not increase the occurrence of cardiac events,it has high safety and is worthy of wide c

关 键 词：改良腔内心电图定位技术 乳腺甲状腺外科 颈内静脉输液港 生理盐水柱法 导丝导电法 

分 类 号：R737.9[医药卫生—肿瘤]