彩色多普勒超声引导下塞丁格PICC置管术的护士学习曲线分析

摘要

Objective To explore the nurses' learning status of Learning curVe of color Doppler ultrasound guided puncture in peripherally inserted central catheter (PICC) with seldinger technique.Methods Totals of 40 cases receiVed color Doppler ultrasound guided puncture in peripherally inserted central catheter (PICC) with seldinger technique were diVided into four groups by the catheter indwelling time,and each group ( 10 cases ) was one Learning curVe stage.Many index were detected such as the operating time,ratio of successful puncture at the first time,good ratio of catheter indwelling,ratio of complication,failure rate and so on,and Learning curVe was analysed.Results The aVerage operating time of group A was (99 ± 12.0) min,group B was (93 ± 12.6) min,group C was (89 ± 11.8 ) min,group D was (51 ± 4.0) min,which showed that the operating time was gradually reduced,the rate of successful puncture at the first time was increased from70％ to 100％,the rate of complication was decreased from 10％ to 0％.The operating time of group A and group B was(93.53 ± 12.57 )min higher than that of group C and group D (57.56 ± 8.48 )min,and the difference was statistically significant(t =11.126,P ＜0.01).Ratio of successful puncture at the first time and good ratio of catheter indwelling of group A and group B was 75％ and 70％ lower than 100％ and 100％ in group C and group D,and the difference was statistically significant ( x2 =5.714,7.059,respectiVely; P ＜ 0.05or P ＜ 0.01 ) and no difference was detected in ratio of complication and failure ratio ( P ＞ 0.05 ).Conclusions The learning curVe of color Doppler ultrasound guided puncture in peripherally inserted central catheter (PICC) will be mature after performing 20 cases.%目的 探讨护士掌握彩色多普勒超声引导下塞丁格PICC植入术的学习曲线.方法 选取采用彩色多普勒超声引导下塞丁格置人PICC的患者40例为研究对象,根据置管时间顺序分为四组,每组10例,每组为一个学习曲线阶段,比较各组的置入时间、一次穿刺成功率、导管送人良好率、并发症发生率及失败率,分析学习曲线.结果 平均置入时间A组(99±12.0) min,B组(93±12.6) min,C组(89±11.8)min,D组(51 ±4.0)min,时间逐渐减少,一次穿刺成功率由70％提高到100％,并发症发生率由10％降到0.A组+B组的置入时间(93.53±12.57)min高于C组+D组(57.56±8.48) min,差异有统计学意义(t=11.126,P＜0.01)；A组+B组的一次穿刺成功率(75％)、导管送入良好率(70％)也均低于C组+D组(均为100％),差异均有统计学意义(x2分别为5.714,7.059;P ＜0.05或P＜0.01)；但并发症与失败率差异均无统计学意义(P＞0.05).结论 彩色多普勒超声引导下塞丁格PICC置管术经过20例手术可达到熟练程度.