乳腺癌患者经颈外静脉置管送管困难的原因分析及对策

目的探讨经颈外静脉置入PICC送管困难的原因,提高送管成功率。方法总结分析12例患者置入PICC时发生送管困难的原因及对策。结果颈外静脉送管困难的原因在于颈外静脉的特殊解剖结构、血管变异及放化疗造成的血管损伤、血管痉挛、对血管的评估是否充分、血管的条件等。结论经颈外静脉置管作为PICC静脉置管的补救措施,应充分评估置管可能存在的困难,排除置管困难的因素,评估置管过程,做好调整导管的准备,确保置管成功。

Difficulty in catheterization via external jugular vein in breast cancer patients: causes and countermeasures

Objective To explore causes of difficulty in PICC insertion through external jugular vein in breast cancer patients,and to improve success rate of insertion.Methods Twelve patients with breast cancer had difficulty in inserting PICC via external jugular vein.Causes and corresponding strategies were analyzed and summarized.Results The difficulties in PICC insertion via external jugular vein were attributed to special anatomic structure of the external jugular vein,vascular variation,vascular injury induced by chemoradiotherapy,angiospasm,inadequale evaluation of blood vessel,and poor condition of blood vessel.Conclusion External jugular vein acts as a remedial approach to PICC insertion.We should evaluate potential difficulties in PICC insertion,eliminate the causes,assess process of PICC insertion,and prepare for adjusting PICC,in an effort to ensure success PICC insertion.