运用导管漂浮原理预防经外周穿刺置入中心静脉导管异位颈内静脉的临床实践

目的运用导管漂浮原理预防经外周穿刺置入中心静脉导管(peripherally inserted central catheter,PICC)异位颈内静脉。方法将2012年9月到2014年1月400例拟行PICC置管的患者按照单双号分为对照组、试验组,每组200例。采用体表定位结合超声实时观察,确认导管进入锁骨下静脉后,试验组(200例)即从末端分离导丝和导管,撤出导丝3cm,继续送至预测量长度。对照组(200例)采用传统方法置入PICC。比较两组患者颈内静脉异位率的差异。结果试验组无颈内静脉异位,对照组颈内静脉异位率为16.5%,两者差异有统计学意义(P<0.05)。结论运用导管漂浮原理可以有效预防PICC异位颈内静脉。

Prevention of peripherally inserted central catheters malposition into jugular vein using the floating catheter principle

Objective To prevent peripherally inserted central catheter（PICC） malposition into jugular vein using the floating catheter principle. Methods Totally 400 patients with PICC from September 2012 to January 2014 were divided into two groups. In the experimental group,the catheter was separated from the guide wire after confirming the correct catheter position by surface location combining with ultrasonic,and the guide wire was removed 3cm and then the catheter was inserted into the vein. The incidence of tip malposition into jugular vein was compared between the two groups. Results The incidence of tip malposition into jugular vein in the experimental group was significantly lower than that of the control group（0 versus 16.5%,P〈0.05）. Conclusion Application of the floating catheter principle can effectively prevent the incidence of PICC malposition into jugular vein.