超声定位加改良塞丁格技术对静脉穿刺困难患者置入PICC的应用探讨

摘要

ObjectiveInvestigate the clinical effect of ultrasonic localization and modified Seldinger Technique in Peripherally Inserted Central Catheter (PICC).Methods187 cases of intubation patients were chosen from June 2012 to March 2015 in our hospital. Deifne the 98 cases of modiifed PICC companied with ultrasonic localization as the observed group (OG), while deifne another 89 cases of traditional PICC as the control group (CG). Analyze the success rate and the complication incidence rate of the PICC from both the two groups.ResultsThe success rate for once puncture of the OG was obviously higher than that of the CG. Moreover, the complication incidence (including errhysis in puncture sites, limb swelling, mechanical phlebitis, thrombus, catheter infection) rate of the OG decreased signiifcantly.ConclusionPICC integrated with B-ultrasonic localization and modiifed Seldinger Technique is a practical and safe catheter indwelling method with high success rate, and shows greater advantages towards patients with restlessness or poor venous condition.%目的：探讨超声定位加改进后的改良塞丁格技术在经外周静脉置入中心静脉导管（Peripherally Inserted Central Catheter，PICC）中的临床应用效果。方法选取2012年6月～2015年3月我院置入PICC的患者187例，将超声定位并改进后PICC置管术98例设为观察组；传统PICC置入法89例设为对照组，分析两组穿刺成功率和并发症发生率。结果观察组一次穿刺成功率明显高于对照组，相关并发症包括：穿刺处渗血、肢体肿胀、机械性静脉炎、血栓、导管感染发生率显著降低。结论 B超定位加改良塞丁格技术并改进后行PICC置管是一种实用、安全、成功率高的置管方法，对躁动、静脉条件差的患者更显其优势。