B超引导下改良塞丁格技术在肿瘤患者PICC置管中的应用

目的比较改良塞丁格技术超声引导下经外周中心静脉置管(PICC置管)术与传统PICC置管方法的效果。方法 60例行PICC置管的晚期恶性肿瘤患者随机分为对照组和观察组,每组30例。对照组采用传统的肉眼直视下穿刺操作的方法置管,观察组采用经B超引导下改良塞丁格技术穿刺置管技术,观察两组一次穿刺置管成功率、置管后导管脱出、出血和皮下淤血、静脉炎、血栓的发生率。结果观察组一次穿刺置管成功率显著高于对照组;而导管脱出、出血和皮下淤血、静脉炎、血栓发生率显著低于对照组(P<0.05)。结论 B超引导下改良塞丁格技术PICC置管,成功率高,并发症少,安全可靠。

The application of PICC catheterization with modified Seldinger technique under the guidance of ultrasound in cancer patients.

Objective To compare the effect of modified Seldinger technique under the guidance of ultrasound for peripherally inserted central venous catheter （PICC） catheterization with the traditional method of PICC catheterization. Methods Sixty patients with late stage malignant tumor performed regular PICC catheterization were randomly divided into control group and observation group, 30 cases in each group. Patients in control group were applied with conventional catheter puncture method under naked eyes, and patients in observation group were applied with modified Seldinger technique for PICC catheterization under the guidance of ultrasound. The successful rate of puncture and incidence rates of catheter escape, hemorrhage, subcutaneous ecchymosis, phlebitis and thrombosis were compared between these 2 groups. Results The successful rate in observation group was significantly higher than that of control group. The incidence rates of catheter escape, hemorrhage, subcutaneous ecchymosis, phlebitis and thrombosis were significantly lower than those of control group （ P 〈 0. 05 ）. Conclusion The PICC catheterization with modified Seldinger technique under the guidance of ultrasound has higher successful rate with less complications and high safety and reliablity.