两种中心静脉置管方法的临床应用比较  

The application of different approach for central venous catheterization

作　　者：杨国凯[1] 罗开元[1] 刘文卓[1] 王明春[1] 毛文源[1] 李波[1] 

机构地区：[1]云南省第二人民医院普通外科,云南昆明650021

出　　处：《肠外与肠内营养》2004年第2期86-88,共3页Parenteral & Enteral Nutrition

摘　　要：目的 :对比两种中心静脉导管的置管方法特点及并发症。　方法 :采用一次性经外周静脉置入中心静脉导管 (PICC)和单腔中心静脉导管 (CVC)。观察 2 4 0例病人中 ,CVC组 1 2 0例 ,应用单腔中心静脉导管行锁骨下静脉穿刺至上腔静脉 ;PICC组 1 2 0例 ,应用一次性导管经外周静脉置入中心静脉。　结果 :①置管成功率 :PICC组1 1 7/ 1 2 0 ,占 97.5 % ;CVC组 1 2 0 / 1 2 0 ,占 1 0 0 %。②气、血胸并发症 :PICC组无血气胸 ;CVC组 1例 ,占 0 .83%。③导管移位 :PICC组 1 0例 ,占 8.33% ;CVC组 1例 ,占 0 .83%。④静脉炎发生率 :PICC组 2例 ,占 1 .6 7% ;CVC组无一例发生。⑤导管堵塞 :PICC组 1 7例 ,占 1 4 .1 7% ;CVC组 9例 ,占 7.5 %。　结论 :PICC置管是一种安全、有效的中心静脉置管方法 ,部分治疗可取代锁骨下静脉穿刺导管 。Objectives: To compare the different approach for cetral venous catheterization(CVC). Methods: The disposable peripherally inserted central catheter(PICC) and the single lumen central venous catheter were used. Patients needing long time iv therapy were enrolled in the study. There were 240 patients in two groups( n =120:120).In Group A, the single lumen central venous catheters were placed into superior vena cava via subclavian vein.And in Group B, PICCs were placed into superior vena cava via peripheral vein. Results: ①Success rate: 97.5%(117/120) for PICC and 100%(120/120) for CVC. ②No pneumothorax or hemothorax in PICC group while 1 case (0.83%) of pneumothorax was found in CVC group. ③Catheter translocation happened in 10 cases (8.33%) in PICC group and 1 case (0.83%) in CVC group. ④Phlebitis was noticed in 2 cases (1.67%) in PICC group but none in CVC group. ⑤Catheter occlusion rate: 14.17% for PICC and 7.5% for CVC.Conclusions: PICC is safe and can partly substitute the central catheterization via subclavian venous access.

关 键 词：中心静脉置管术 一次性导管 静脉穿刺 并发症 肿瘤 

分 类 号：R472.9[医药卫生—护理学]