肿瘤患儿经头皮静脉和肘静脉行中心静脉置管的效果比较

目的探讨肿瘤患儿经头皮静脉行中心静脉置管(peripherally inserted central catheter,PICC)的可行性。方法 2009年2月至2011年10月选择在南方医科大学珠江医院儿科被确诊并需住院化疗的肿瘤患儿66例为研究对象,按随机数字表法将其分为肘静脉组(n=36)和头皮静脉组(n=30)。比较两组患儿穿刺时和留置期间并发症发生情况及穿刺完成时间和导管留置时间。结果经头皮静脉和肘静脉留置PICC的两组患儿中,66例患儿均置管成功。但经肘静脉患儿的导管异位发生率为11.1%,经头皮静脉置入PICC的患儿无导管异位发生,差异有统计学意义(P<0.05)。两组患儿在置入PICC的一次性成功率、送导管困难和拔除导丝困难、导管留置期间并发症发生率及穿刺完成时间和导管留置时间方面的差异无统计学意义(P>0.05)。结论经头皮静脉留置PICC可提高置管的成功率,且安全、方便,值得临床推广使用。

Effect Comparison of Inserting Peripherally Inserted Central Catheter via Elbow Vein and Scalp Vein in Infants

Objective To probe the feasibility of inserting peripherally inserted central catheter（PICC） via scalp vein in infants. Methods From February 2009 to December 2011, 66 hospitalized infants with malig- nant tumor were enrolled in the study. The infants were randomized into elbow vein group （n= 36） and scalp vein group（n=30）. Comparisons were conducted on the incidence rate of complications during inser- ting and indwelling PICC, catheterization time and PICC indwelling time of both groups. Results The suc- cess rate of catheterization was 100.0% in all subjects. The probability of catheter-misplacement in elbow vein was 11.1%, but zero in scalp vein. There were significant difference between the two groups（P〈 0.05）. The one-time success rate of PICC catheterization, the catheterization difficulty, the difficulty of removal of the guide wire, the incidence rate of complications during indwelling PICC ,the puncture com- pletion time and catheterization time of two groups had no significant difference（P〉0. 05）. Conclusion Intubating PICC via scalp vein in infants provides a safe and convenient way to elevate the success rate of catheterization, and thus deserves further clinical application.