超声引导下使用改良 Seldinger 技术置入PICC 导管的临床观察

摘要

Objective To evaluate the operation methods of PICC placement under ultra-sound guidance with modified Seldinger technique.Methods 140 PICC patients with cancer chemotherapy from were randomly divided into seldinger group and control group.In the seldinger group,83 patients were treated with modified seldinger technique to place PICC under ultrasound guidance.In the control group,57 patients were treated with conventional PICC.Success rate of PICC,puncture site bleeding,retention time,extubation reason,and incidence rate of complica-tion were detected.Results The retention time was higher in the seldinger group than that in the control group and the complication rate was lower in the seldinger group than that in the control group.The results revealed that the difference was statistically significant(P <0.05).Extubation reason of experimental group was lower than that in the control group,which showed no statisti-cally significant (P >0.05).Conclusion PICC placement under ultrasound guidance with modi-fied Seldinger technique is a secure and reliable method.It could overcome the difficulties of the poor condition of the blood vessels,improve the patient comfort,reduce the incidence of complica-tions,increase PICC retention time and improve the quality of life of cancer patients.%目的：探讨经超声引导下使用改良 Seldinger 技术置入 PICC 导管的规范操作方法，以减少 PICC 置管并发症发生。方法将行 PICC 置管的140例肿瘤化疗患者随机分成2组，采用超声引导下使用改良 Seldinger 技术置入 PICC 导管83例患者设为实验组，常规行 PICC 置管的57例患者设为对照组，比较2组患者1次 PICC 置管成功率、穿刺点出血情况、留置时间、拔管原因、并发症发生率。结果实验组留置时间长于对照组、并发症发生率低于对照组，2组比较差异具有统计学意义（P ＜0．05）。在拔管原因方面，实验组虽低于对照组，但2组差异无统计学意义（P ＞0．05）。结论超声引导下使用改良Seldinger 技术置入 PICC 导管是肿瘤患者化疗较安全可靠的给药途径，能够解决因血管条件不佳需 PICC 置管的问题，可提高置管患者舒适度，降低 PICC 置管并发症发生率，增加 PICC 导管留置时间，提高肿瘤患者生活质量。