基于心电图P波引导PICC导管尖端定位的观察

目的 观察心电图P波引导PICC导管尖端精确定位的效果.方法 选择2015年12月-2016年12月住院行PICC置管的病人120例,按数字表法随机分为观察组和对照组,各60例.观察组采用腔内心电图,监测P波振幅和形态变化,P波最高尖时再退出导管2 cm固定.对照组PICC导管送至预置长度后,用超声排除同侧颈部静脉无异位后固定.两组病人均行X线摄片定位.结果 观察组病人导管尖端最佳位置56例多于对照组43例,观察组无导管异位,对照组4例异位,差异有统计学意义(P<0.05).结论 应用心电图P波引导PICC导管尖端定位准确,避免了导管异位等的发生,病人输液安全.

Observation of the tip position of PICC catheter based on tall upright Pwave of electrocardiogram

Objective To observe the effect of precision location of PICC catheter tip guiding by the tall upright P wave.Methods 120 cases were divided randomly into observation group and control group (n=60,respectively),who were admitted in our hospital for planning PICC implanted from Dec 2015 to Dec 2016.Connected the electrode via normal saline to the catheter tip.The catheter tip was located by the changing of the P wave voltage and shape continuously,withdrawing about 2 cm when the P wave reaching its maximum voltage.Verified the location of the tip by veins ultrasound and X-ray.Results The incidence of optimal position was 56 vs 43,heterotopia was 0 vs 4 between the observation group and the control group,the difference was significant (P<0.05).Conclusion The tall upright P wave of intravenous ECG was helpful to guide and evaluate PICC tip position,which could reduce the incidence of the catheter position was too deep,too shallow or heterotopia.