肺结核患者应用超声引导下改良Seldinger技术实施经外周静脉置入中心静脉导管的效果研究

目的对比分析超声引导下改良Seldinger技术与盲穿法实施经外周静脉置入中心静脉导管(peripherally inserted central venous catheters,PICC)在肺结核患者中的应用效果。方法搜集2016年3月至2018年3月昆明市第三人民医院住院治疗的150例行PICC的肺结核患者作为研究对象。根据PICC置管方式进行分组,将接受行盲穿法进行PICC置管的70例患者纳入对照组,将行超声引导下改良Seldinger技术进行PICC置管的80例患者纳入观察组,对比两组患者的置管效果。结果观察组一次性穿刺成功率为97.5%(78/80),一次性置管成功率为100.0%(80/80),均明显高于对照组的85.7%(60/70)和92.9%(65/70),差异均有统计学意义(χ^2值分别为7.05、5.91,P值分别为0.008、0.015)。观察组置管后并发症发生率为5.0%(4/80),明显低于对照组的21.4%(15/70),差异有统计学意义(χ^2=9.11,P=0.003)。结论超声引导下改良Seldinger技术对肺结核患者进行PICC置管的效果优于盲穿法,具有较高的安全性。

Study on the effect of peripherally inserted central venous catheter in patients with pulmonary tuberculosis using ultrasound-guided modified Seldinger technique

Objective To compare and analyze the application effect of ultrasound-guided modified Seldinger technique and blind puncture for the implementation of peripherally inserted central venous catheter(PICC)in patients with pulmonary tuberculosis(PTB).Methods A total of 150 patients with PTB underwent PICC in Kunming Third People’s Hospital from March 2016 to March 2018 were collected as research subjects,and then divided into two groups according to the mode of PICC catheterization.Concretely,70 patients who received PICC catheterization by blind puncture were included in the control group,and 80 patients who underwent PICC catheterization with ultrasound-guided modified Seldinger technique were included in the observation group,and the effects of catheterization were compared between the two groups.Results The success rates of one-time puncture and catheterization in the observation group were 97.5%(78/80)and 100.0%(80/80),respectively,which were significantly higher than those in the control group(85.7%(60/70)and 92.9%(65/70),respectively),with the statistically significant differences(χ^2=7.05 and 5.91,P=0.008 and 0.015,respectively).The incidence of complications after catheterization in the observation group was significantly lower than that in the control group(5.0%(4/80)vs.21.4%(15/70)),with the statistically significant differences(χ^2=9.11,P=0.003).Conclusion The effect of ultrasound-guided modified Seldinger technique on PICC catheterization in patients with PTB is better than that of blind puncture,and it has higher safety.