生理盐水联合无导针器技术在超声引导改良塞丁格PICC置管术中的效果观察

目的 探讨生理盐水联合无导针器技术在超声引导改良塞丁格PICC置管术中的应用效果。方法 选择2016年1月—2018年3月在厦门市某三级甲等医院行超声引导改良塞丁格PICC置管的患者为研究对象,采用随机数字表法将置管患者随机分为对照组（1 268例）与观察组（1 270例）,对照组采用传统的超声引导套件进行超声引导改良塞丁格技术置管,观察组采用生理盐水联合无导针器技术进行超声引导下改良塞丁格技术置管,比较2种置管方法置管费用、1次穿刺成功率、PICC置管时并发症发生率。结果 观察组每例患者置管总费用均为1 884元,对照组每例患者置管总费用均为2 023元,观察组患者置管总费用低于对照组;观察组1次穿刺成功率高于对照组（P<0.05）;2组患者PICC置管时误入动脉、神经损伤、送管困难等并发症发生率差异均无统计学意义（P>0.05）。结论 超声引导改良塞丁格PICC置管中应用生理盐水联合无导针器技术,能够降低患者的置管费用,提高1次穿刺成功率,且不会增加置管时相关并发症的发生。

Effect of Normal Saline Combined with Acuductor-free Ultrasound-guided Modified Seldinger Technique in PICC Placement

Objective To evaluate the effect of normal saline combined with acuductor-free ultrasound-guided modified Seldinger technique in PICC placement. Methods Between January 2016 and March 2018, a total of 2,538 hospitalized patients undergoing PICC placement were assigned to control group(n=1 268)and treatment group(n=1 270) randomly. The control group received traditional ultrasound-guided modified Seldinger technique in PICC placement, and the treatment group normal saline combined with acuductor-free ultrasound-guided modified Seldinger technique in PICC placement. The catheterization cost, success rate of first puncture and complication incidence in the two groups were compared. Results Catheterization cost of the treatment group was remarkably decreased when compared with that in the control group [￥1884vs.￥2023] and success rate of first puncture of the treatment group was significantly higher than that of the control group (P<0.05). There was no statistically significant difference between the control group and the treatment group in the incidence of complications such as arterial error, nerve injury and catheterization difficulty during PICC catheterization (P>0.05). Conclusion Normal saline combined with acuductor-free ultrasound-guided modified Seldinger technique is applicable in PICC placementas it can effectively improve the success rate of first puncture,reduce complication incidence during the catheterization and the total cost of catheterization.