微导丝辅助送管困难性PICC导管置入的观察

目的:观察微导丝辅助送管困难性PICC导管置入的成功率。方法:将63例患者随机分为观察组31例,对照组32例。2组患者均采用改良Seldinger法联合超声引导穿刺,观察组在DSA监视下使用微导丝辅助送管,对照组在DSA监视下直接送管。比较2组PICC置管的到位率以及平均累积X线照射时间。结果:送管成功率观察组为96.8%,对照组为46.9%,2组比较差异有统计学意义(P0.05)。观察组平均X线累积照射时间9.6分钟,对照组15例导管到位患者平均累积X线照射时间18.6分钟,17例患者在20分钟内未送管成功,改为微导丝辅助后,在平均X线累积照射时间10.5分钟内全部送管到位。结论:微导丝引导显著提高了送管困难性PICC导管置入的成功率,同时减少了患者和操作者X线照射时间。

Observation on the Insertion of Difficult Feeding Type PICC Interoduced by Micro-wire

Objective:To observe the success rate of micro-wire interoducing the insertion of difficult feeding type peripherally inserted central catheter (PICC).Methods:All 63 patients were randomized into 31 cases of the observation group and 32 cases of the control group.Both groups accepted modified Seldinger method combined with ultrasound guided puncture,the patients in the observation group received micro-wire assisting the insertion of the catheter on the foundation of DSA,and the patients in the control group were inserted directly under the observation of DSA.Average cumulative X-ray irradiation time and PICC success rate of both groups were compared.Results:Feeding success rate of the observation group was 96.8％,higher than 46.9％ of the control group,and the difference had statistical meaning (P ＜0.05).Average cumulative X-ray irradiation time of the observation group was 9.6minutes,while the time for 15 patients with successfully insertion in the control group was 18.6minutes,17 patients failed in 20 minutes,and changed into micro-wire assisting;the time was 10.5minutes and succeeded completely.Conclusion:Interoducied by micro-wire could significantly raise the success rate of difficult feeding type PICC,at the same time,and reduce X-ray irradiation time of the patients and the operators.