| 林娟.基于CT成像在提升胸部病变肿瘤患者PICC置管风险控制水平中的应用[J].上海护理,2023,23(11): |
| 基于CT成像在提升胸部病变肿瘤患者PICC置管风险控制水平中的应用 |
| Application of CT-based Imaging in risk control of PICC in patients with thoracic tumor |
| DOI： |
| 中文关键词: CT 胸部病变 PICC 导管长度。 |
| 英文关键词:CT chest lesions picc catheter length. |
| 基金项目:基于HIBCH的支链氨基酸代谢调控探索三阳性乳腺癌治疗靶点及机理 |
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| 中文摘要: |
| 目的 提高胸部病变（胸腔积液、纵膈淋巴结转移、左或右肺全切除术后）肿瘤患者行PICC置管前导管长度预测量的准确性，减少置管相关并发症。方法 选取2020年02月至2022年02月在我院肿瘤科住院，存在胸部病变（胸腔积液、纵膈淋巴结转移、左或右肺全切除术后）由于治疗需要行PICC置管术的55例肿瘤患者。运用回顾性分析方法，调取患者置管后2周内CT图像，通过CT成像计算患者右胸锁关节至理想导管尖端位置（上腔静脉下1/3段或上腔静脉与右心房连接处）的长度，再将此数值加上置管前体外测量法测得的穿刺点距右胸锁关节的长度即为患者需置入PICC导管的预测量长度。将该数据与患者PICC导管实际留置长度及置管前用传统体外测量法横“L”法测得的导管长度进行数据对比，分析差异性。结果 对于存在胸部病变的55例肿瘤患者，运用传统体外测量法测得导管长度(38.2±2.32cm)与导管实际留置长度(36.11±2.47cm)比较有显著差异(P =0.00)，置管后调管率100%；运用CT影像测量法测得导管长度(36.6±2.42cm)与导管实际留置长度(36.11±2.47cm)无显著差异(P＞0.01)。结论 运用CT成像计算PICC导管置入长度，增强了对于临床上胸部病变肿瘤患者PICC导管长度预测量的准确性较高，可以减少了反复调整导管留置长度所引发的风险及相关并发症。 |
| 英文摘要: |
| Objective To improve the accuracy of catheter length prediction before PICC catheterization in patients with thoracic lesions (pleural effusion, mediastinal lymph node metastasis, and after total left or right lung resection) and to reduce catheterization-related complications. Methods A total of 55 tumor patients hospitalized in the oncology department of our hospital from February 2020 to February 2022 with chest lesions (pleural effusion, mediastinal lymph node metastasis, after left or right total lung resection) who required PICC catheterization due to treatment were enrolled. Using retrospective analysis method, the CT image of the patient was retrieved within 2 weeks after catheterization, and the length of the patient's right sternoclavicular joint to the ideal catheter tip position (inferior 1/3 segment of the superior vena cava or the junction between the superior vena cava and the right atrium) was calculated by CT imaging, and then this value was added to the length of the puncture point from the right sternoclavicular joint measured by in vitro measurement before catheterization, which is the predicted length of the patient's need to insert the PICC catheter. The data were compared with the actual indwelling length of the patient's PICC catheter and the length of the catheter measured by the traditional in vitro measurement method horizontal "L" method before catheterization, and the differences were analyzed. Results For 55 patients with chest lesions, the length of the catheter (38.2±2.32 cm) and the actual indwelling length of the catheter (36.11±2.47 cm) were significantly different by traditional in vitro measurement (P=0.00), and the rate of catheter adjustment after catheter placement was 100%. There was no significant difference between the length of the catheter (36.6±2.42 cm) and the actual indwelling length of the catheter (36.11±2.47 cm) by CT imaging measurement (P>0.01). Conclusion The use of CT imaging to calculate the length of PICC catheter insertion enhances the accuracy of PICC catheter length prediction in patients with thoracic lesions, and can reduce the risk and related complications caused by repeated adjustment of catheter indwelling length. |
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