彩色多普勒超声在处置 PICC 导管置入异位及血栓并发症中的应用价值

目的：探讨彩色多普勒超声在经外周静脉置入中心静脉导管（ peripherally ineserted central catheter ，PICC）异位后实时处置引导正位的作用及出现血栓等并发症时的应用价值。方法选取经外周静脉血管行导管置入术的122例肿瘤化疗患者为研究对象，在X线发现有导管异位后立即在彩超引导下行位置调整及再固定，并对实施PICC导管置管后的肿瘤化疗患者或化疗结束即将拔管的肿瘤患者行外周血管彩超检查。结果122例中，X线发现有18例导管置入发生异位，均在彩超引导下一次调整成功；并经彩超检查发现有10例外周血管发生血栓形成。结论彩色多普勒超声有助于对肿瘤化疗患者置管过程中出现的导管尖端异位准确复位，并对置管后出现的血栓等并发症准确判断，为临床处置提供及时协助。

Value of color doppler ultrasound in adjustment malposition of PICC catheter and diagnosis of venous thrombosis

Objective To study the value of color Doppler ultrasound in adjustment malposition of PICC catheter in real time and diagnosis of venous thrombosis .Methods 122 cancer patients receiving chemotherapy who accepted peripheral inserted central -catheter （ PICC） were selected for the study .The patients who were found malposition of PICC catheter on the X-ray tube were received adjustment of catheter immediately by ultrasound guided in real time and the catheter were refixed .The patients who were performed chemotherapy through PICC catheter and the patients whose chemotherapy was going to end and excubated afterward were treated with peripheral vascular ultrasonography .Results In 122 patients,malposition of PICC catheter was found in 18 patients.The 18 patients received adjustment malposition of PICC catheter by ultrasound-guided successfully only with one time .Peripheral vascular thrombosis was found in 10 patients.Conclusion Adjustment malposition of PICC catheter by ultrasound guided in real time is very useful for cli -nicians.Color Doppler ultrasound is also useful in diagnosis of the complications such as peripheral vascular thrombosis in patients who accepted PICC .