| 胡守紫,李 丽,毛鑫群,付 立.超声引导联合改良塞丁格技术行上臂贵要静脉、肱静脉穿刺置入中心静脉导管的随机对照研究[J].上海护理,2018,18(10): |
| 超声引导联合改良塞丁格技术行上臂贵要静脉、肱静脉穿刺置入中心静脉导管的随机对照研究 |
| Comparison of the clinical effect of ultrasound-guided modified Seldinger peripherally inserted central catheter in basilic vein with brachial vein of the upper arm: a randomized, controlled study(The Third Affiliated Hospital of Second Military Medical University, the Chinese People |
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| 中文关键词: 超声引导 PICC置管 贵要静脉 肱静脉 |
| 英文关键词:Ultrasonic guidance PICC catheterization basilic vein brachial vein |
| 基金项目:中国人民解放军第二军医大学第三附属医院院内基金(15HL002)。 |
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| 中文摘要: |
| 【】目的：探讨超声引导联合改良塞丁格技术(Modified Seldinger Technique,MST)行外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)置管时选择上臂贵要静脉或肱静脉的可行性优势,为寻找最佳的PICC穿刺静脉提供理论依据。方法：80例预行PICC的晚期癌症患者,被随机分为贵要静脉组和肱静脉组,每组各40例,穿刺前分别测量自然状态下穿刺部位同水平面两组血管的内径及距皮肤表面距离,比较两组患者PICC一次穿刺成功率、置管成功率、术中出血量以及术后并发症等情况。结果：两组患者在年龄、性别、体重指数、合并症以及肿瘤类型方面比较均无统计学差异。与肱静脉相比,同水平面的肘上贵要静脉内径大(4.979±0.659 mm vs. 4.056±0.713mm),距皮肤表面距离短(6.390±1.844mm vs. 10.195±2.111mm),且穿刺术中出血少(1.090±0.215g vs. 1.403±0.234g),差异均具有统计学意义(p<0.001),但两组患者术后并发症无统计学差异 (p=0.644)。所有80例患者均被成功置入PICC导管,置管成功率均为100%；尽管一次穿刺成功率两组间无统计学差异(p=0.166),但贵要静脉组一次穿刺成功率要高于肱静脉组(97.5% vs. 90.0%)。结论：超声引导联合MST肘上PICC置管,经贵要静脉置管具有提高一次穿刺成功率、减少术中出血的优势,PICC置管时,可优先考虑。 |
| 英文摘要: |
| Objectives To investigate the clinical effect of ultrasound-guided modified Seldinger peripherally inserted central catheter (PICC) in basilic vein or brachial vein of the upper arm and provide the theoretical basis for selecting the best puncture vein in PICC. Methods Eighty chemotherapy patients with cancer were recruited to participate in the randomised, controlled study. Forty were assigned to the basilic vein group, and 40 were assigned to the brachial vein group. Background data (including vascular diameter, distance of the blood vessel from the skin surface), and data related to PICC placement, and complications after PICC placement were collected to compare the effects of the two methods. Results: All of 80 PICCs were successfully inserted. There was no significant difference between two groups in sex, age, body mass index (BMI), and cancer categories. Compare to the brachial vein, the inner diameter of the basilic vein in the same horizontal line was larger (4.979±0.659 mm vs. 4.056±0.713mm, P<0.001), the distance of the blood vessel from the skin surface was shorter (6.390±1.844mm vs. 10.195±2.111mm, P<0.001), and the amount of bleeding during the puncture was less (1.090±0.215g vs. 1.403±0.234g, P<0.001). There was no significant difference between two groups in complications after PICC placement (P=0,644). Although there was no significant difference between two groups in the success rate of the first puncture (P=0.166), the success rate of the basilic vein group was higher than the brachial vein group (97.5% vs. 90.0%). Conclusions ultrasound-guided modified Seldinger PICC in the basilic vein catheter of the upper arm has the advantage of increasing the success rate of the first puncture and reducing the amount of bleeding in operation. |
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