新型扩皮手法在乳腺癌患者超声引导下经外周中心静脉置管中的应用效果

目的探讨新型扩皮手法在乳腺癌患者超声引导下经外周中心静脉置管(power peripherally inserted central catheter,PICC)中的应用效果。方法便利抽样选择2014年6月至2015年6月首都医科大学附属北京潞河医院普通外科收治的89例乳腺癌患者,按照入院时间段分成对照组42例和观察组47例,对照组采用常规扩皮手法进行超声引导下PICC置入术,观察组采用新型扩皮手法进行超声引导下PICC置入术,比较两组患者术后淋巴漏的发生情况。结果对照组42例患者均置管成功,其中发生淋巴漏患者5例;观察组47例患者均置管成功,无一例淋巴漏发生。两组淋巴漏发生率比较,差异有统计学意义(P0.05)。结论乳腺癌患者行超声引导下PICC置入术应精细操作,新型扩皮手法通过调整扩皮的角度和深度,可以最大限度地降低组织损伤,减少淋巴漏的发生,该扩皮手法值得在临床推广和借鉴。

Application Effect of the New Type of Skin Expansion Technique on Breast Cancer Patients with Ultrasonic-guide PICC

Objective To discuss the application effect of new type of skin expansion techinique on breast cancer patients with ultrasonic-guide PICC.Methods By convenience sampling,89 cases of breast cancer patients were selelcted and divided into control group (n =42)and observation group (n =47).The control group was applied with routine skin expansion technique to conduct ultrasonic-guide PICC,while the observation group was applied with the new type of skin expansion technique to conduct ultrasonic-guide PICC.The incidence of postoperative lymphatic leakage was compared between two groups.Results The success of PICC placement was 100% in con-trol group,while 5 cases had lymphatic leakage.All 47 cases in observation group were all had success PICC place-ment,with no incidence of lymphatic leakage(P <0.05).The difference of lymphatic leakage in two groups was statistically significant(P <0.05).Conclusions Modifying the angle and depth of skin expansion for placement of PICC using ultrasound guidance can maximum reduce the tissue injury rate and reduce the incidence of lymphatic leakage for breast cancer patients,which is worth for clinical promotion.