特重度烧伤瘢痕患者应用经外周静脉穿刺置入中心静脉导管置管一例的护理体会

目的了解经外周静脉穿刺置入中心静脉导管(peripherally inserted central venous catheters,PICC)在大面积疑难烧伤病例中的作用及其使用情况。方法分析2016年7月上海市某三级甲等综合性医院烧伤科收治1例大面积深度烧伤后瘢痕增生患者,施行PICC置管的过程。结果由于该患者全身大面积瘢痕增生及手术部位限制无法建立外周静脉通道或中心静脉通道(central venous catheters,CVC),遂在超声引导赛丁格穿刺下成功置入PICC导管,留置52d,并顺利完成了相关治疗后拔管。结论该案例PICC的成功实施,拓宽了其在烧伤及疑难置管病例中的使用范围。

PICC Cathetering on Scar Nursing Experience of 1 Case of Patient with Severe Burn

Objective To investigate the application of peripherally inserted central venous catheters (PICC)in complicated burn cases.Methods One patient with severe burn and received PICC was analyzed. Results Routine intravenous access or central venous catheters(CVC)cannot be established due to loca-tion deformity of peripheral vein caused by scar contracture.Thus,ultrasound guided Seidinger puncture technique was performed and then PICC was established successfully.After dwelling within the central veins for 52 days,the catheter was removed with expected completion of treatment.Conclusions This successful cathe-terization of PICC case broadens the PICC utilization on burn cases and other complicated cases.