心腔内电图用于上臂输液港留置期间导管尖端定位的可行性  

Feasibility of intracavitary electrocardiogram for tip location of upper arm port during indwelling period

作　　者：梁晓红[1] 杨静[1] 朱吕[1] 周愉[1] 蔡均[1] Liang Xiaohong;Yang Jing;Zhu Lü;Zhou Yu;Cai Jun(Gynecology Department,The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院妇科,重庆400010

出　　处：《护理学杂志》2025年第8期51-55,共5页Journal of Nursing Science

基　　金：重庆医科大学附属第二医院护理骨干科研资助计划(2021-04)。

摘　　要：目的探讨上臂输液港留置期间采用心腔内电图定位导管尖端位置的可行性,为上臂输液港留置期间的安全使用提供参考。方法采用方便抽样法,选取151例留置上臂输液港的妇科肿瘤患者为研究对象。按标准流程采集体表心电图和心腔内电图,通过两者的P波形态变化判断输液港导管尖端位置,最后行胸部X线摄片定位。以胸部X线摄片定位结果将输液港导管尖端位置分为理想位置、位置深、位置浅3组,分析心腔内电图相关量化指标的截断值及诊断效能。结果心腔内电图P波形态定位上臂输液港留置期间导管尖端位置准确性80.8%。心腔内电图P波振幅与体表心电图P波振幅的比值可作为鉴别理想位置与位置深、位置浅的有效指标(AUC=0.721、0.643),其值为1.820~2.230时提示导管尖端位置准确。结论心腔内电图定位技术可用于上臂输液港留置期间导管尖端定位,准确性高,可保障上臂输液港的安全留置。Objective To explore the feasibility of intracavitary electrocardiogram(IC-ECG)for identifying catheter tip of upper arm port during indwelling period.Methods A total of 151 gynecologic cancer patients with upper arm port were recruited by conve-nience sampling method.Routine surface ECG(SECG)and IC-ECG were performed to identify the changes in P wave.Different changes in P wave indicated different positioning of the catheter tip.Finally,all patients received chest X-ray examination to determine the actual position of the catheter tip:ideal position,deep position,and shallow position.The cut-off values and diagnostic efficacy of IC-ECG parameters were analyzed.Results The accuracy of catheter tip location predicted by changes in P wave was 80.8%.IC-ECG P wave amplitude to SECG P wave amplitude ratio(IP/SP)could be an effective indicator to distinguish between ideal position and deep position,and also between ideal position and shallow position(area under the receiver operating curve=0.721 and 0.643,respectively),and the cut-off value of IP/SP was in the interval of 1.820-2.230.Conclusion IC-ECG can be used to determine the catheter tip of upper arm port during the indwelling period for its high diagnostic accuracy,which may facilitate to ensure the safe indwelling of upper arm port.

关 键 词：输液港 心腔内电图 导管 尖端位置 心电图 灵敏度 特异度 静脉输液 护理 

分 类 号：R471[医药卫生—护理学]