血管超声检查联合反送导丝检查法在中心静脉置管中的应用

目的 探讨血管超声联合反送导丝检查法在中心静脉置管过程中的作用。方法 实验组628例在采取常规方法置入中心静脉导管的基础上加用血管超声检查联合反送导丝检查法,通过血管超声检查颈内静脉、锁骨下静脉、腋静脉内有无导管影或导管影是否正常,以及检查退出导丝能否顺利反送到预定刻度,来判断导管有无异位和打折;对照组555例只采取常规方法置管,最终通过X线检查有无导管异位和导管打折。结果 实验组发生导管异位5例,异位率0.8%。对照组发生导管异位33例,异位率5.9%。两组患者置管导管异位率进行统计学分析,差异有显著意义（P〈0.01）。结论 血管超声检查联合反送导丝检查法对中心静脉导管异位和导管打折,能早期发现,及时调整,从而起到较好的预防作用。

Application of ultrasound and guide wire check against catheter malposition in the central venous catheterization

Objective To explore the value of ultrasound and guide wire check avoid catheter malposition in the central venous catheterization. Method Cancer patients were chosen to participate in this study. In the experiment group ,628 patients- catheterization used ultrasound and guide wire check to avoid central venous catheter malposi- tion. Then the tip position of central catheters were confirmed by postoperative chest X-ray. In the control group, 555 patients accepted chest X-rayafter catheterization to conform wether the catheters-. tips were in malposition. Re- sult In the experiment group, 5 catheters were not at the target position, and the malposition rate was 0.8-. In the control group,33 catheters were not at the target position, and the malposition rate was5.9 %. The malposition rate was significate difference between the two groups（P〈0.01）. Conclusion Ultrasound and guide wire check was effective methods to discover and prevent catheter malposition.