全程超声引导在危重症患儿PICC置管中的应用  

Application of Whole-Process Ultrasound-Guided PICC Catheterizationin Critically Ill Children

作　　者：王丹[1] 王龙君 方艳艳 曾庆虎[2] WANG Dan;WANG Longjun;FANG Yanyan;ZENG Qinghu(Department of Pediatric Intensive Care Unit(2),the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Ultrasound,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院小儿重症监护病区(2),河南郑州450052 [2]郑州大学第一附属医院超声科,河南郑州450052

出　　处：《河南医学研究》2024年第23期4261-4265,共5页Henan Medical Research

基　　金：河南省高等学校重点科研项目(23A320015)。

摘　　要：目的探究全程超声引导在危重症患儿经外周静脉置入中心静脉导管(PICC)置管中的应用效果。方法选取2022年3—5月PICC置管患儿31例为对照组,采用超声引导下改良塞丁格技术联合心腔内电图法进行置管。2022年6—8月PICC置管患儿38例为观察组,在对照组的基础上将超声应用于置管全程。比较两组患儿首次送鞘成功率、置管过程中颈内静脉异位率、导管尖端准确率、导管留置期间并发症发生率。结果观察组首次送鞘成功率高于对照组(P<0.05),置管过程中颈内静脉异位率低于对照组(P<0.05),导管尖端准确率高于对照组(P<0.05),导管留置期间并发症发生率低于对照组(P<0.05)。结论将超声应用于PICC置管全程既能保证精准穿刺,又能保证置管路径的准确性,降低颈内静脉异位的发生,还有助于导管尖端的精准定位。Objective To explore the application effect of whole-process ultrasound-guided peripherally inserted central catheter(PICC)catheterization in critically ill children.Methods A total of 31 pediatric patients with PICC catheterization from March to May 2022 were selected as the control group,and the catheterization was performed using ultrasound guided modified Seidinger technique combined with intracardiac electrocardiogram.From June to August 2022,38 pediatric patients with PICC catheterization were selected as the observation group,and ultrasound was applied throughout the entire catheterization process on the basis of the control group.The success rate of the first sheath delivery,the malposition rate of internal jugular vein during catheterization,the optimal position rate of catheter tip,and the incidence of complications during catheter indwelling were compared between the two groups of children.Results The success rate of the first sheath delivery in the observation group was higher than that in the control group(P<0.05),the rate of internal jugular vein ectopia during catheterization was lower than that in the control group(P<0.05),the accuracy of the catheter tip was higher than that in the control group(P<0.05),and the incidence of complications during catheter placement was lower than that in the control group(P<0.05).Conclusion The application of whole-process ultrasound-guided PICC catheterization can not only ensure accurate puncture,but also ensure the accuracy of catheterization path,reduce malposition rate of internal jugular vein,but also ensure the optimal position of catheter tip.

关 键 词：危重症患儿 超声引导 经外周置入中心静脉导管 

分 类 号：R605.979[医药卫生—急诊医学]