两种途径放置中心静脉导管的临床比较

目的通过分析经外周及中心两种途径放置中心静脉导管的病例，比较两种方法的可行性、优越性、以及后期并发症情况。方法检索经外周静脉及经中心静脉置入中心静脉导管的相关文献。回顾经外周静脉放置中心静脉导管（PICC）110例以及经锁骨下静脉穿刺置入单腔中心静脉导管（CVC）110例的临床资料，进行分析和总结。对比两组资料的置管成功率、血气胸的发生率、导管堵塞、移位以及导管相关性感染等的发生率；总结这两种方法在可行性、优越性和后期并发症等方面的差异。结果对所有观察项进行分析比较，除血气胸并发症具有统计学差异（P〈0．05）；其余观察项两组间对比无统计学差异（P〉0．05）。结论PICC置管可达到与CVC相同的效果，但其在预防血气胸这一严重并发症方面更具优势；是更加安全、有效的中心静脉置管方法。

The comparison of two different routs for central venous catheterization in clinical analysis

Objective Both kind of cases of the different routs for central venous catheterization were analyzed to compare the feasibility complications and advantages. Methods After studying some relative literatures of the two different routs for central venous catheterization( CVC ), we reviewed 110 cases that the single lumen venous catheter were placed into superior vena cave via subclavian vein and 110 cases that the peripherally inserted central venous catheter(PICC) were placed into surperior vena cava via peripheral vein. Comparing the rate of success, complication of pneumothorax or hemothorax, rate of catheter occlusion, rate of catheter translocation and phlebitis, the time for placing the catheter, to find the differences between the two groups about the feasibility complications and advantages. Results The statistics difference of catheter translocation rate is significant in complication of pneumothorax or hemothorax rate. Other factors make no sense in statistics after analyse by the SPSS system. Conclusion PICC method has an exact same effect as CVC method dose. While it is superior in some other factors, especially when it comes to preventing hemopneumothorax. The PICC methods is a safer and more effective way for central venous catheterization.