融入胸部CT测量对预测肺癌患者耐高压型PICC最佳尖端位置的影响  

Eff ects of integrated chest CT measurement on prediction of optimal tip position of PICC in patients with lung cancer

作　　者：王娟 刘勇世 菅利华 滕鑫 贠俊茹 赵阿红 韩小荣 刘静 殷玉环 WANG Juan;LIU Yongshi;JIAN Lihua;TENG Xin;YUN Junru;ZHAO Ahong;HAN Xiaorong;LIU Jing;YIN Yuhuan(Department of Thoracic Surgery,the Second Affi liated Hospital of Air Force Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学第二附属医院胸腔外科,西安710038

出　　处：《空军航空医学》2024年第5期426-430,共5页AVIATION MEDICINE OF AIR FORCE

摘　　要：目的本研究旨在探讨融入胸部CT测量法在预测肺癌患者耐高压型经外周置入中心静脉导管(peripherally inserted central catheter,PICC)最佳尖端位置中的应用效果。方法选取来自2023年8—12月在陕西省某三甲医院胸外科行PICC置管的205例肺癌患者。采用计算机随机法将患者随机分为对照组(传统的体表横“L”测量法)102例和观察组(融入胸部CT测量法)103例。主要评价指标为PICC导管最佳尖端位置的准确率,次要评价指标为置管后30 d内并发症的发生率。结果2组PICC最佳尖端位置的准确率分别为86.41%和30.39%,观察组高于对照组(OR=14.560,95%CI:7.202~29.437,P<0.001)。调整性别、年龄和BMI的影响后,2组间最佳尖端位置的准确率差异仍具有统计学意义(OR=16.383,95%CI:7.824~34.308,P<0.001)。观察组30 d内导管滑脱的风险低于对照组(1.94%vs 11.76%,OR=0.154,95%CI:0.033~0.718,P=0.017),2组间机械性静脉炎的发生率差异无统计学意义(P>0.05)。结论融入胸部CT测量法可提高PICC最佳尖端位置准确率,降低导管滑脱的发生率。本研究作为一项护理新技术,研究结果可推广到肺癌等其他需要常规行胸部CT检查的患者领域,在不额外增加辐射和费用的前提下,可提高PICC测量的准确性。Objective To explore the applicability of integrated chest CT measurement in predicting the optimal tip position of Power PICC in patients with lung cancer.Methods A total of 205 patients with lung cancer were selected who had undergone PICC in the Thoracic Surgery Department of a hospital between August 2023 and December 2023.The patients were randomly divided into the control group(conventional horizontal"L"measurement,n=102)and the observation group(integrated chest CT measurement,n=103)using the computer random number method,The primary index was the accuracy of the optimal PICC tip position while the secondary one was the incidence of complications within 30 days of catheterization.Results The accuracy of the optimal PICC tip position in the two groups was 86.41%and 30.39%,respectively,and was much better in the observation group than in the control group(OR=14.560,95%CI:7.202~29.437,P<0.001).After adjusting the influence of gender,age and BMI,the accuracy of the optimal tip position was still statistically different between the two groups(OR=16.383,95%CI:7.824~34.308,P<0.001).The risk of catheter slippage within 30 days was significantly lower in the observation group than in the control group(1.94%vs 11.76%,OR=0.154,95%CI:0.033~0.718,P=0.017).There was no significant difference in the incidence of mechanical phlebitis between the two groups(P>0.05).Conclusion The integrated chest CT measurement can significantly improve the accuracy of the optimal PICC tip position,and reduce the incidence of complications.The results of this study can be applied to lung cancer patients or other patients who need routine chest CT examination,which can improve the accuracy of PICC measurement without increasing exposures to radiation and costs.

关 键 词：CT测量 肺癌 经外周置入中心静脉导管 最佳尖端位置 

分 类 号：R734.2[医药卫生—肿瘤]