超声引导下改良塞丁格技术行PICC置管的临床观察

目的：探讨超声引导下改良塞丁格技术行 PICC置管在食管癌患者中的应用效果。方法选取2014年1月至2015年5月高州人民医院胸外科250例需留置PICC行静脉化疗及静脉营养治疗的食管癌患者为研究对象,将其随机分为观察组和对照组,各125例,观察组采用超声引导下改良塞丁格技术 PICC 置入法,对照组采用盲穿 PICC置入法。结果两组穿刺置管成功所用的时间比较,对照组平均时间(19.536依6.002) min,观察组平均时间(17.800依5.053)min,差异无统计学意义(P>0.05)；一次穿刺成功率比较,差异有统计学意义( P<0.05)；观察组置管时疼痛比对照组轻,观察组置管术后第1天、第3天渗血低于对照组( P<0.05)；观察组置管期间静脉炎、静脉血栓、周围组织损伤等并发症发生率低于对照组( P<0.05)。结论超声引导下改良塞丁格技术 PICC 置入法可解决外周血管直视下无法直接穿刺置管的患者穿刺困难的问题,置管成功率高、并发症少,可增加患者的舒适度,值得临床推广。

Clinical observation of ultrasound-guided modified Seldinger technique for PICC

Objective To explore the effect of application of the ultrasound-guided modified Seldinger tech-nique for PICC on patients of esphagus cancer. Methods Totally 250 cases of patients with esophagus cancer in Thorac-ic Surgery of Gaozhou People's Hospital from January 2014 to May 2015 who had adopted the indwelling PICC line intra-venous chemotherapy and parenteral nutrition therapy in this study were randomly divided into observation group and control group, 125 cases in each group. The observation group employed the improved ultrasound-guided PICC of Seldinger technology, while the control group adopted the blind PICC placement method. Results The puncture and in-dwelling time of the two groups were compared. The mean time of the control group were (17. 800 ±5. 053) min and the mean time of the observation group were (19. 536 ±6. 002) min respectively. The difference was statistically significant in terms of the first-time success rate of the puncture between the two groups; there was less pain during intubation for observation group than the control group. The oozing of blood of the observation group was less than that of the control group in the first day and third day after the surgery; the incidence rate of complications such as phlebitis, venous thrombosis , peripheral tissue injury and so on of the observation group was less than that of the control group during intu-bation. Conclusion Ultrasound-guided improved PICC placement method can solve the difficulty when it is impossible to directly insert the central catheter in the peripheral vascular. It is worthy of wide promotion with high success rate, fe-wer complications and more comfort of patients.