不同规格工具不同方法测量 PICC 置管长度的比较

摘要

Objective To explore the effect of different specifications of the tapes and different methods on measuring the length of peripherally inserted central catheter (PICC), and to find the minimum error of the tape and standardize the methods of measuring the length of PICC in order to improve the accuracy of the length of PICC.Methods Fifty nurses were randomly chosen, and every nurse respectively measured the same PICC nursing teaching simulation by three different specifications of the tapes and two different methods .According to PICC operation guide, firstly, the PICC nursing teaching simulation was put the catheter position , namely, the lateral upper arm tube outreached 90 °.Three points were marked in the simulation including the puncture point which was 2 cm above elbow in the middle of vein, the right sternoclavicular joint and the third intercostal space.The three tapes respectively measured the length from the puncture point to right sternoclavicular joints and to the third intercostal space.The third tape measured the length by two different methods , and method 1:sectional measurement the length from the puncture point to right sternoclavicular joints and the length from the right sternoclavicular joints to the third intercostal space , and method 2:direct measurement the length from the puncture point to right sternoclavicular joints and then along the right margin of the sternum straighted down to the third intercostal space.Results The average lengths measured by tape 1, 2 and 3 were respectively (42.20 ±0.51) cm, ( 42.43 ±0.46) cm, (42.30 ±0.44) cm, compared with the average 42.30 cm difference had no statistical significance (P>0.05), the ruler 3 measured data of normal distribution is more concentrated;The average lengths of the PICC measured by two different methods were respectively (42.39 ± 0.48) cm and (41.78 ±0.57) cm, two methods of measuring PICC catheter length values were the mean comparison, the difference had statistical significance ( P <0.05), the method 1 measured data of normal distribution is more concentrated .Conclusions The length of PICC measured by the third tape and method 1 is more accuracy, and we recommend the length from the puncture point to right sternoclavicular joints and the length from the right sternoclavicular joints to the third intercostal space piecewise measured by 1.9 cm width of the tape as the length of PICC.%目的：探讨不同规格的皮尺和方法对测量PICC置管长度的影响，以寻求误差最小的皮尺和规范统一的方法应用于PICC测量，提高PICC置管长度的准确性。方法随机选择外科护师50名，每名护师分别用3种不同规格皮尺和2种方法测量同一个PICC护理教学模拟人，根据PICC操作指南，先将模拟人摆成置管体位，置管侧上臂外展90°，在模拟人上标记三点：穿刺点为肘上2 cm处正中静脉、右胸锁关节、第三肋间。用三把皮尺分别测量自穿刺点至右胸锁关节至第三肋间的长度和，再用尺子3分别用两种方法测量，方法1：分段测量穿刺点至右胸锁关节和右胸锁关节至第三肋间的长度和；方法2：直接测量穿刺点至右胸锁关节再沿胸骨右侧缘垂直向下到第三肋间的长度和。结果尺子1，2，3测量的PICC置管长度分别为（42．20±0．51），（42．43±0．46），（42．30±0．44）cm，与均值42．30 cm比较差异均无统计学意义（P＞0．05），尺子3测得的数据正态分布更集中；两种方法测量PICC置管长度值与均值比较，差异均有统计学意义（P＜0．05），方法1测得的数据正态分布更集中。结论尺子3方法1测量PICC置管长度更精确，建议使用此种尺子第二种方法测量PICC置管长度。