经外周静脉置入中心静脉导管的临床应用（640例经验）

目的 总结经外周静脉置入中心静脉导管（PICC）的成功和置管后的并发症。方法 对640例有长期输液适应的病人行经外周静脉置入中心静脉导管使用美国B－D公司生产的一次性PICC（Peripherally Inserted Central Catheter)导管。外径为0．8mm（Fr3)、(Fr4),1.6mm(Fr5)结果 本组穿刺成功率95．1％（包括：穿刺2次成功）,失败率为4．9％。609例插管成功后的临床表现：（1）上臂胀感占12％;（2）重症静脉炎在一周左右发生占2．6％;（3）导管异位占3％,经调整后恢复正常位置;（4）导管堵塞率在20天以上90天以内发生的占21．4％。（5）清洗堵塞导管成功率占33．1％,失败率占66．9％。结论 经外周静脉置入中心静脉导管操作简单,可长期安全保留在血管内,有临床推广应用价值。

PICC in clinical practice(experience in 640 cases)

Objective To analysis the success rate and complications of PICCin clinical practice. Methods 640 cases with long-term infusion therapeutisc subjexts received PICCs wich were made of soft silicon rubber with external diameter of 0.8mm(Fr3),1.2mm(Fr4) and 1.6mm(Fr5)(Becton Dickenson,UT,USA). Results Of 640 cases,the success rate of venipuncture was 95.1% and the failure rate was 4.9%.The physical symptom occurred after the puncture in 609 success cases included:(1)upper-arm distention(12%);(2)severe phlebitis occurred within 1 week(2.6%);(3)malposition(3%);(4)tube clog occurred from 20 days to 90 days after the puncture (21.4%);(5)success rate of cleanout was 33.1%,failure rate was 66.9%. Conclusions PICC was a simpler method and could be kept in vein safely for a long-time,so it could be widely used in clinical practice.