超声引导下结合改良塞丁格技术置入PICC导管在慢性老年患者中的临床应用

摘要

目的 探讨超声引导下结合改良塞丁格技术置入PICC导管在慢性老年患者静脉输液治疗中的临床应用效果.方法 选取2014年5月至2017年10月本院收治的80例患者肘部均无可触及或可视的血管,传统方法无法置入PICC导管的患者.使用血管超声引导系统结合改良塞丁格技术,记录置管成功率、导管异位、穿刺点出血、感染、静脉炎发生率、患者舒适度等方面进行评价.结果 使用超声引导下结合改良塞丁格技术,置管成功率97.5％,且置管时无1例并发症发生,置管后并发症发生率低,舒适度高.结论 使用超声引导下结合改良塞丁格技术置入PICC导管,提高置管穿刺成功率和减少导管异位、穿刺点出血、伤口感染、静脉炎发生率及提高患者舒适度,安全实用,值得临床推广应用.%Objective To investigate the clinical application of ultrasound-guided PICC catheterization in intravenous infusion in elderly patients with chronic diseases.Methods Eighty patients in our hospital from May 2014 to October 2017 had no palpable or visible blood vessels in their elbows,and PICC catheter could not be implanted by traditional method.PICC were implanted with modified Seldinger technique (MST) under the guidance of vascular ultrasound.The success rate of catheterization,the incidence of catheter misplacement,puncture point bleeding,infection,phlebitis,and patient comfort were evaluated.Results Using ultrasound-guided modified Seldinger technique,the success rate of catheterization was 97.5％,and no complication occurred during catheterization.The complication rate after catheterization was low,and the patient comfort was high.Conclusion The use of ultrasound-guided modified Seldinger technique in inserting PICC catheter can increase the success rate of catheterization,reduce the incidence of catheter misplacement,puncture point bleeding,infection,phlebitis,and improve patient comfort,safe and practical,which is worthy of clinical application and promotion.