摘要
目的探讨呼吸运动在判断PICC置管异位中的作用。方法将400例行PICC置管患者随机分为对照组和观察组各200例,对照组按常规置入PICC,置管后行X线摄片判断导管位置;观察组置管后根据呼吸运动观察PICC导管水柱的波动以判断置管后有无异位,并据此调整导管位置。结果置管后X线摄片显示,对照组PICC置管异位率为10.5%,观察组异位率为1.0%,两组比较,差异有统计学意义(P<0.01)。结论在PICC置管后行呼吸运动致导管水柱波动,可间接反映导管异位情况;根据导管水柱波动调整导管位置可显著降低导管异位率,提高一次性置管成功率。
Objective To explore the role of respiratory motion applied to determine malposition of peripherally inserted central cathe- ter （PICC） lines. Methods A total of 400 patients were randomly divided into a control group and an observation group, with 200 in each group. The control group received conventional procedures for PICC insertion and the tip of PICC line was confirmed with an X-ray; in the observation group, PICC tip location was determined by means of respiratory motion-induced fluctuation of water co]umn in PICC line, and the tip was readjusted if malpositioned. Results The rate of malposition confirmed by the use of X-ray ra- diography was 10.5 % in the control group and 1.0% in the observation group, with significant difference between the two groups （P〈0.01）. Conclusion Respiratory motion-induced fluctuation of water column in PICC line can indirectly reflect PICC tip position, so that it can be used to readjust the tip to decrease malposition and increase success rate of catheterization.
关键词
肿瘤
化疗
PICC
导管异位
呼吸运动
tumor
chemotherapy
peripherally inserted central catheter（PICC）
malposition of catheter tip
respiratory motion
