脑损伤昏迷患者术后PICC与锁骨下静脉置管的疗效观察

目的：探讨PICC与锁骨下静脉置管在脑损伤昏迷患者术后置管输液治疗的疗效。方法回顾性分析79例行PICC及63例行锁骨下静脉置管输液治疗的脑损伤昏迷患者的临床资料，比较2种治疗方法的一次性置管成功率及导管置入相关并发症的发生率。结果 PICC一次穿刺成功率94.9％（75／79），锁骨下静脉置管一次穿刺成功率为74.5％（47／63），差异有统计学意义（P＜0.05）；PICC组发生机械性静脉炎、堵管高于锁骨下静脉组（P＜0.05），而导管脱落、非计划性拔管的机率小于锁骨下静脉组（P＜0.05），两组在导管位、导管相关性感染的发生率上差异无统计学意义（ P＞0.05）。结论 PICC与锁骨下静脉置管在脑损伤昏迷患者术后输流治疗中有简单易行、护理方便，留置时长等优点，相比较而言，PICC更具有优势。

Efficacy of PICC and Subclavian Vein Catheter in Coma Patients with Brain Injury

Objective To discuss the therapy efficacy of peripherally inserted central catheter （ PICC） and subclavian vein catheter in coma patients with brain injury.Methods A retrospective analysis of the clinical data of coma patients with brain injury, in which 79cases with PICC and 63 cases with subclavian vein catheter.The disposable catheter success rate and the incidence of catheter -related complications were compared in the two groups.Results A disposable catheter success rate of 94.9%（75/79）in the PICC group, and 74.5%（47/63）in the subclavian vein catheter group , the difference was statistically significant （ P〈0.05 ）.The incidence of mechanical phlebitis and catheter blockage in the PICC group were more than the subclavian vein catheter group （ P〈0.05 ） , and the incident of catheter off and un-planned catheter removal were less （ P〈0.05 ）.The incidence of catheter malposition , catheter related infections in these two groups was no statistically significant （ P〉0.05 ）.Conclusions The PICC and subclavian vein catheter used in the coma patients with brain injury has the advantages of simple , convenient nursing , long indwelling time.By comparison , the PICC has mire has more advantages.