超声引导下经肘上留置中心静脉导管的效果观察

目的 探讨超声引导下肘上经外周静脉置入中心静脉导管（PICC）的临床效果.方法超声引导下在肘上PICC置管92例（观察组）,对比传统肘部或肘下PICC盲穿96例（对照组）穿刺成功率、舒适度等指标.结果 两组一次穿刺成功率差异无统计学意义（P＞0.05）;导管尖端位置正确率、置管后舒适度评分观察组显著高于对照组（P＜0.05,P＜0.01）;颈内静脉异位率、静脉炎发生率、置管后对生活的影响评分观察组显著低于对照组（P＜0.05,P＜0.01）.结论 超声引导下肘上PICC置管解决了盲穿PICC的弊端,降低了颈内静脉异位和静脉炎的发生率及留置PICC对日常生活的影响,提高了PICC尖端位置的正确率和患者的舒适度.

Effect of Peripheral Inserted Central Catheters via Above Elbow under Ultrasound Guidance

Objective To explore clinical effect of peripheral inserted central catheters （PICC） via above elbow under ultrasound guidance. Methods The achievement ratio and comfort index were compared between 92 patients received PICC via above elbow under ultrasound guidance （experiment group） and 96 patients accepted PICC via traditional elbow or below elbow without guidance （control group）. Results The difference of the two groups in achievement ratio only for one time was not statistically significant （P 〉 0. 05 ） ; the precision rate of catheter tip position and comfort index after insertions in experiment group were significantly higher than those in control group （ P 〈 0. 05, P 〈 0. 01 ） ; incidence rates of internal jugular vein malposition and phlebitis, index of life effect after insertions in experiment group were significantly lower than those in control group （P 〈 0. 05, P 〈 0. 01 ）. Conclusion PICC via above elbow under ultrasound guidance may resolve the abuse of PICC without guidance, reduce incidence rates of internal jugular vein malposition and phlebitis, and effect of daily living after PICC insertions, and improve the precision rate of catheter tip position and comfort degree of patients.