改良PICC置管技术在169例肺癌患者化疗中的应用

目的研究改良经外周静脉置入中心静脉导管（PICC）置管技术对导管异位的影响。方法将169例肺癌置管患者随机分为试验组（88例）与对照组（81例），试验组在行HCC置管术送管至25cm时，助手用手紧贴患者锁骨上窝按压穿刺侧颈内静脉和颈外静脉下端；对照组采取常规歪头的方法。统计两组导管异位的发生率。结果试验组仅有1例导管被送人颈外静脉，导管颈部异位发生率为1．1％（1／88）；对照组导管异位发生率为11．1％（9／81），两组比较差异无统计学意义（X^2=7．3636，P〈0．01）。结论肺癌患者PICC置管过程中，术者采取相应的干预手法可明显减少导管异行进入颈静脉的并发症。

Application of the improved peripherally inserted central career technique in chemotherapy for 169 patients with lung cancer

Objective To evaluate the influence of pressing technique on the malposition of catheter dur- ing the operation of peripherally inserted central catheter (PICC). Methods Totally, 169 patients with lung cancer were randomly divided into treatment group (n = 88), in which the external and internal jugular veins were pressed at the supraclavicular fossa by the assistant when the catheter was navigated in 25 cm, and control group (n = 81), in which the patients were called to turn their angle of mandible to supraclavicular fossa when the cathe- ter was sent in. Results There were only one patient whose catheter was sent in external jugular vein in treatment group and nine patients whose catheters were sent in external and internal jugular vein in control group. The inci- dence of malposition of catheter was significantly different between two groups (1.1% vs. 11. 1% , X2 =7. 3636, P < 0. 01). Conclusion The pressing technique can reduce the incidence of malposition of catheter into external and internal jugular vein during the operation of PICC.