摘要
目的探讨血管超声结合塞丁格（MST）技术在改进经外周静脉置人中心静脉导管（PICC）的成功率和减少并发症方面的适用性和优越性。方法选取108例采用血管超声结合MST技术行PICC置管的患者及108例采用常规直视盲穿PICC的患者，比较两组一次穿刺成功率、一次置管成功率、置管所需时间、早期并发症的发生率。结果超声组一次穿刺成功率88．89％高于盲穿组的72．22％（P=0．002）；一次置管成功率82．41％高于盲穿组的57．41％（P=0．000）；穿刺失败率0．09％低于盲穿组的7．4％（P=0．017）；导管颈内异位2例（P=0．003）、穿刺点渗血2例（P=0．017）、静脉炎3例（P=0．001）、导管堵塞1例（P=0．010）分别低于盲穿组的13、10、18、9例；两组置管所需时间超声组〈15min15例，15～25min72例，〉25min21例；盲穿组〈15min12例，15～25min70例，〉25min26例，两组比较差异无统计学意义（P=0．685）。结论血管超声结合MST技术行PICC置管具有定位靶向血管、提高穿刺置管成功率、减少局部组织损伤和并发症的优势，为患者提供了更优化的PICC的技术方式。
Objective To investigate the applicability and superiority of modified Seldinger technique （MST）. Methods Totally 108 patients receiving peripherally inserted central catheter （PICC） through vascular ultrasound combined with MST technology were enrolled as MST group and another 108 patients receiving PICC using traditional direct vision method as control group. The first puncture success rate, PICC success rate, catheterization time required, and early complication rate were compared between these two groups. Results The first puncture success rate was 88.89% in MST group and 72. 22% in control group （ P = 0. 002 ） ; the catheterization success rate was 82.41% in MST group and 57.41% in control group （ P = 0. 000）. In the MST group, there were two cases where the catheter within neck was ectopic （ P = O. 003 ）, two cases experienced bleeding at the puncture sites （P = 0. 017 ）, three cases had phlebitis （P = 0. 001 ）, and one case suffered from catheter blockage （P =0. 010）. In the control group, the corresponding numbers were 13, 10, 18, and 9. However, the time required for PICC showed no significant difference between these two groups （P = 0. 685）. In the MST group, 15 cases were catheterized in less than 15 minutes, 72 cases between 15 and 25 minutes, and 21 cases for more than 25 minutes. In the control group, 12 cases were catheterized in less than 15 minutes, 70 cases between 15 and 25 minutes, and 26 cases for more than 25 minutes. Conclusion PICC through MST can be more effective in positioning the targeting blood vessels, increasing the success rate of catheter insertion, reducing various tissue damages, and lowering potential complications.
出处
《中华临床营养杂志》
CAS
2012年第3期178-181,共4页
Chinese Journal of Clinical Nutrition
