改良塞丁格技术联合血管超声在乳腺癌患者术后化疗经外周静脉置入中心静脉导管置管中的作用

目的探讨改良塞丁格技术联合血管超声在乳腺癌患者术后化疗经外周静脉置入中心静脉导管（PICC）置管中的临床效果。方法将接受术后化疗乳腺癌患者120例按照随机数字表法分为观察组和对照组各60例，观察组采用改良塞丁格技术联合血管超声PICC置管，对照组采用传统盲穿PICC置管，比较两组患者一次穿刺成功率、一次置管成功率、置管后机械性静脉炎及静脉血栓的发生率。结果观察组一次穿刺成功率、一次置管成功率、置管后机械性静脉炎发生率分别为91．67％、100％和3．33％，对照组一次穿刺成功率、一次置管成功率、置管后机械性静脉炎发生率分别为76．67％、86．67％和45％，两组比较差异均有统计学意义（P=0．0061，P=0．0434，P〈0．0001）。观察组置管后静脉血栓发生率为0，对照组置管后静脉血栓发生率为6．67％，两组比较差异无统计学意义（P=0．1187）。结论将改良塞丁格技术联合血管超声PICC置管应用于乳腺癌患者术后化疗置管成功率高，置管后机械性静脉炎发生率低，具有较高的临床应用价值。

Role of modified Seldinger technique combined with vascular ultrasonography in the placement of peripherally inserted central catheters in patients with breast cancer undergoing postoperative chemotherapy

Objective To investigate the role of modified Seldinger technique combined with vascular uhrasonography in the placement of peripherally inserted central catheters （PICC） in patients with breast cancer undergoing postoperative chemotherapy. Methods Totally 120 patients with breast cancer undergoing postoperative chemotherapy were equally divided into the observation group and the control group using the table of random number. In the observation group, PICC were placed using the modified Seldinger technique combined with vascular uhrasonography; in the control group, the PICC were placed using the traditional blind puncture technique. The success rate of first puncture, success rate of first placement, and the incidences of mechanical phlebitis and thrombosis were compared between two groups. Results The success rate of first puncture, success rate of first placement, and the incidences of mechanical phlebitis were 91.67% , 100% , and 3.33% , respectively, in the observation group and 76. 67%, 86. 67% , and 45% , respectively, in the control group （ P = O. 0061, P = 0. 0434, and P 〈 0. 0001 ）. However, no significant difference was found on the incidence of thrombosis between the two groups （P = 0. 1187）. Conclusion Modified Seldinger technique combined with vascular ultrasonography is efficient and safe for PICC placement for patients with breast cancer undergoing postoperative chemotherapy.