改良Seldinger技术应用于血管超声引导下上臂置入PICC的效果

目的探讨改良Seldinger技术应用于血管超声引导下上臂置入PICC的临床效果。方法将2009年7-12月行PICC的120例患者按置管穿刺时间分为对照组和试验组各60例,试验组采用改良Seldinger技术在血管引导下行上臂PICC置管,对照组采用常规的盲穿置管,比较两组患者PICC置管成功率、操作时间、置管后机械性静脉炎及静脉血栓的发生率。结果试验组的置管成功率、机械性静脉炎和静脉血栓的发生率分别为98.33%、0和0,对照组分别为86.67%、13.46%和11.54%,差异均有统计学意义（P〈0.05）。结论采用改良Seldinger技术在血管引导下上臂PICC置管的成功率高,置管后机械性静脉炎和血栓的发生率比较低,尽管操作时间有所延长,但仍有较高的临床应用价值。

Effects of Modified Seldinger Technique in Vascular Ultrasound-guided PICC Placement of Upper Arm

Objective To explore the application effect of modified Seldinger technique in vascular ultrasound-guided peripherally inserted central catheter（PICC） placement of upper arm.Methods From July to December 2009,120 patients undergoing PICC were divided into the control group and the experimental group according to the puncture time.The patients in the control group were treated with the routine technique of inserting PICC.The patients in the experimental group were treated with vascular ultrasound-guided PICC placement of upper arm combined with modified Seldinger technique.Comparisons were conducted on the tube insertion completion rate,incidence rate of mechanical phlebitis and postoperative thrombosis rate in the patients of the two groups.Results The tube insertion completion rate,incidence rate of mechanical phlebitis and postoperative thrombosis rate of the experimental group were 98.33%,0,0 respectively.While those in the control group were 86.67%,13.46%,11.54% respectively.Significant differences were observed between the two groups（P〈0.05）.Conclusion Modified Seldinger technique with vascular ultrasound-guided PICC placement of upper arm has higher tube insertion completion rate and lower incidence rates of mechanical phlebitis and postoperative thrombosis.Although the operating time is longer,but there is still high clinical value.