超声引导下改良送鞘术结合ECG在血液病患者PICC置管中的应用  

Application of modified seldinger technique under guidance of vascular ultrasound combined with ECG in PICC catheterization in patients with blood diseases

作　　者：黄丽明 黄英姑 文丽彬[1] 赵慧函 覃敏莉 周雪梅[1] HUANG Liming;HUANG Yinggu;WEN Libin(Department of Hematology,the First Affiliated Hospital of Guangxi Medical University,Guangxi,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院血液内科,南宁市530021

出　　处：《河北医药》2024年第15期2336-2338,2342,共4页Hebei Medical Journal

摘　　要：目的 探讨超声引导下改良送鞘术结合心电图(ECG)在血液病患者PICC置管中的应用。方法 选取广西医科大学第一附属医院2021年1月至2023年1月收治的110例血液病患者为研究对象,按照随机数字表法分为对照组(右侧55例,采用塞丁格技术送血管鞘进行)和观察组(右侧55例,采用超声引导下改良送鞘术结合ECG进行)。置管7 d后观察2组穿刺点情况、置管情况、换药次数、一次性成功率、穿刺点出血量以及并发症情况。结果 观察组穿刺点渗血、异常、机械性静脉炎发生率低于对照组(P<0.05)。观察组患者送鞘完成时间短于对照组,置管即刻疼痛评分低于对照组(P<0.05)。96 h内观察组患者换药次数低于对照组(P<0.05)。观察组一次性成功率高于对照组(P<0.05)。观察组患者穿刺点出血量与对照组比较差异无统计学意义(P>0.05)。治疗后,观察组感染、渗液等并发症发生率与对照组比较差异无统计学意义(P>0.05)。结论 超声引导下改良送鞘术结合ECG的成功率更高,能够改善穿刺点情况,缩短送鞘完成时间,降低疼痛,值得临床推广。Objective To investigate the application of modified seldinger technique under guidance of vascular ultrasound combined with electrocardiogram(ECG) in peripherally inserted central catheters(PICC) catheterization in patients with blood diseases.Methods A total of 110 patients with blood diseases admitted to the First Affiliated Hospital of Guangxi Medical University from January 2021 to January 2023 were enrolled,and they were randomly assigned in a 1∶1 ratio to traditional seldinger technique(on the right side,the control group) or modified seldinger technique under guidance of vascular ultrasound combined with ECG(on the right side,the observation group) for 7 days.The puncture points,catheterization,drug dressing frequency,one-time success rate,bleeding volume of puncture point and complications of the two groups were observed.Results The incidence of puncture point bleeding,abnormal bleeding,and mechanical phlebitis in the observation group was significantly lower than that in the control group(P<0.05).The time to completion of introducer sheath insertion in the observation group was significantly shorter than that of the control group,and the immediate pain degree of catheterization was significantly lower than that of the control group(P<0.05).The 96h drug dressing frequency in the observation group was significantly lower than that in the control group(P<0.05).The one-time success rate of observation group was significantly higher than that of control group(P<0.05).There was no difference in blooding volume of puncture point between groups(P>0.05).The incidence of complications(infection and fluid seepage) in the two groups was comparable(P>0.05).Conclusion Modified seldinger technique under guidance of vascular ultrasound combined with ECG has a higher success rate,which can improve the puncture points,shorten the time to completion of introducer sheath insertion,and reduce pain,it is worthy of clinical promotion.

关 键 词：超声引导 改良送鞘术 心电图 血液病 

分 类 号：R552[医药卫生—血液循环系统疾病]