超声引导下经外周静脉置入中心静脉导管置管术在老年患者中的应用

目的 分析超声引导下经外周静脉置入中心静脉导管（PICC）置管术在老年患者中应用的置管成功率和并发症的发生率。方法37例有PICC置管适应证的老年患者，其中18例（48．6％）肘部没有可见或可触及的浅静脉，选择上臂深静脉，采用超声引导下改良的Seldinger穿刺法进行PICC置管，分析置管成功率和并发症发生率。结果37例老年患者，超声引导下PICC置管成功率为100％。PICC管留置时间为（32．0±19．8）d，2例（5．8％）患者分别在置管后第21和39天因为静脉血栓形成而拔管，18例（48．6％）患者的PICC仍在使用。结论应用超声引导技术，使部分肘部无可见或可触及浅静脉的老年患者也能安全置入PICC。

Application of ultrasound-guided peripherally inserted central catheter insertion in elderly patients

Objective To explore the feasibility and complications of ultrasound-guided peripherally inserted central catheter (PICC) insertion in elderly patients. Methods Ultrasound-guided PICC insertion was performed in 37 elderly patients with modified Seldinger's technique. Eighteen (48.6%) patients had invisible or impalpable shallow veins in elbow joints. The post-insertion success rate and complications were analyzed. Results The success rate was 100% among these 37 elderly patients. The indwelling patency duration was (32.0 ± 19.8)days. Two catheters in 2 (5.8%) patients were removed on the 21st and 39th day because of deep venous thrombosis. PICCs remained in place in 18 (48.6%) cases. Conclusions Ustrasound-guided PICC insertion is a safe procedure with high success rate. It can also be applied in patient whose shallow vein is not visible or palpable in elbow joint.