PICC置管过程中支撑导丝撤除时机的临床研究

目的探讨PICC置管过程中支撑导丝撤除时间对导管异位后复位成功率的影响。方法将132例血液病患儿按其是否立即拔出导丝的意愿分为观察组(74例)和对照组(58例),观察组留置PICC结束保留导丝,待X线确认导管尖端位于上腔静脉后撤除导丝;对照组按PICC操作常规送导管至预定的长度后,固定、撤除导丝。观察并比较两组患儿置管相关并发症及导管异位后复位的情况。结果两组PICC相关并发症发生率比较,差异无统计学意义(均P>0.05),观察组导管异位后复位成功率显著高于对照组(P<0.01)。结论留置PICC结束保留导丝,至X线确认导管尖端位置位于上腔静脉后再撤除导丝,有利于导管异位后的复位。

Withdrawal of guided wire during PICC insertion on different occasions

Objective To explore effect of withdrawal of guided wire during PICC insertion on different occasions on successful resetting of catheter after PICC dislocation.Methods A total of 132 leukemia children were randomized into an observation group(n=74) and a control group(n=58).After insertion of PICC,the guided wires were retained in the observation group and were withdrawn at the moment when the tip of the PICC was confirmed to reach superior vena cava under X ray radiation.In the control group,the catheter was advanced until it reached the expected length as the current protocol requires,and soon after,the guided wires were removed.The rates of catheter-related complications,and successful resetting of catheter after PICC dislocation were cpmpared between the two groups.Results There were no significant differences in the rates of complications of PICC between the two groups(P>0.05 for all).After PICC dislocation,the observation group had higher successful resetting of catheter than the control group(P<0.01).Conclusion Dursing PICC insertion,the guided wire should be advanced until the tip of the PICC has been confirmed to reach superior vena cava under X ray radiation,which improves success rate of catheter insertion and benefits resetting of dislocated catheter.