心电精准定位结合超声引导在极低体重儿PICC置管中应用

目的 探讨心电P波变化结合超声引导下头皮钢针穿刺技术判断极低体重儿PICC置管尖端定位的安全性、精准性和一次穿刺成功率。方法 选择行PICC置管的极低体重患儿60例,采用超声引导下头皮针穿刺结合心电定位技术进行实时监控,根据心电图P波型态变化调整PICC导管置入深度,观察穿刺及送管一次成功率及导管尖端到位精准率。结果 60例患儿一次穿刺成功率93.33%,送管一次成功率100%,心电P波型态变化定位极低体重儿PICC导管尖端位置,可行性100%,安全性100%,精准性96.66%。结论 心电技术精准定位结合超声引导头皮针穿刺技术在极低体重儿PICC导管置入过程中,可提高一次穿刺成功率和送管成功率,降低导管异位风险,P波型态变化对导管尖端定位精准、安全可行。

Application of ECG precise positioning combined with ultrasound-guided PICC catheterization in very low birth weight infants

Purpose To evaluate the safety, accuracy and success rate of PICC tip positioning in very low birth weight infants by ECG P wave changes combined with scalp steel needle puncture guided by ultrasound. Methods Sixty infants with very low birth weight who underwent PICC catheterization were selected. Scalp needle puncture guided by ultrasound combined with ECG positioning technology was used for real-time monitoring. The depth of PICC catheterization was adjusted according to the changes of P wave pattern of ECG. Observe the success rate of first puncture and tube feeding and the accuracy rate of catheter tip placement. Results The success rate of first puncture was 93.33%, the success rate of first tube feeding was 100%, and the change of ECG P wave pattern could locate the tip of PICC catheter in very low birth weight infants. The feasibility, safety and accuracy were 100%,100% and 96.66%. Conclusion Accurate positioning of ECG combined with scalp needle puncture guided by ultrasound can improve the success rate of puncture and tube feeding in very low birth weight infants, and reduce the risk of catheterSheterotopic. The change of P-wave pattern is accurate and safe for the tip positioning of PICC catheter.