| 吴俊梅,周兴梅,朱瀛,邢红,方芳.PICC置管方式在综合ICU患者中的临床研究[J].上海护理,2017,17(4): |
| PICC置管方式在综合ICU患者中的临床研究 |
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| DOI： |
| 中文关键词: PICC置管方式 综合ICU患者 临床研究 |
| 英文关键词:the methods of peripherally inserted central catheter, patients in a general intensive care unit, clinical study |
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| 中文摘要: |
| 目的 探讨综合ICU患者外周中心静脉(PICC)置管避免导管异位的有效方法。方法 选择2011年11月至2013年12月在上海市交通大学附属第一人民医院南院重症监护室接受床旁局麻PICC置管(APACHEII>15)危重症患者512例。2011年11月至2012年11月危重症患者265例为对照组,采用传统肘部血管盲穿置管方式。2012年12月至2013年12月危重症患者247例为干预组,置管过程中使用超声引导、脉冲冲管同时予以送入导管。比较两组导管异位发生率。结果 两组患者的性别、年龄、疾病种类、病情危重度、所选择穿刺血管等方面比较无统计学差异。干预组导管尖端位置X线摄片显示在T5下至T8上水平,导管异位发生率显著低于对照组(P<0.05)。结论 外周中心静脉导管(PICC)置管成功为危重症患者静脉药物治疗提供保障,实施置管过程干预是防止导管尖端异位的有效方法。 |
| 英文摘要: |
| 【】Objective: To explore the effective method of peripherally inserted central catheter(PICC) to avoid catheter dislocation for patients in a general intensive care unit(ICU). Methods: A total of 512 critically ill patients(APACHEII>15) received bedside PICC in the ICU room of South Hospital of Shanghai First People"s Hospital affiliated to Shanghai Jiaotong University were enrolled in our study between November 2011 and December 2013. Of those, 265 patients enrolled between November 2011 and November 2012 received the traditional blind method of PICC via elbow vein as the control group, while 247 patients between December 2012 and December 2013 received the new method of PICC under ultrasound guidance and puls-type flushing catheter in line with pushing catheter as the intervention group. The incidence of catheter dislocation between the two groups were compared. Results: There were no differences between the two groups with respect to clinical characteristics of age, gender, diseases, severity of disease and option of punctured veins. In the intervention group, X-ray showed that the top of catherter was below thoracic vertebrae fifth ( T5) and above T8, and the incidence of catheter dislocation was significantly lower than that of the control group(P<0.05).Conclusions: PICC provides a great support for intravenous medication of critically ill patients. Ultrasound guidance as well as puls-type flushing catheter in line with pushing catheter is an effective method to decrease the incidence of catheter dislocation for those patients. |
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