超声引导下改良塞丁格穿刺法在PICC置管困难患者中的应用

摘要

Objective To approach the effect of ultrasound-guided modified Seldinger technique in patients with difficulty in placing periphcrally in8crted central venous catheters (PICC). Methods Sixty-nine patients hospitalized from December 2009 to December 2010 were selected, whose yessels could not be found by the visual and tactile sensation. Ultrasound-guided modified Seldinger technique was adopted to help place PICC. The effect of catheterization was observed. Results The success rate of catheterization in patients was 100.00％; according to the catheter pain scale ( 1 to 3 points), the average score was (1.35± 0.64) points, which was mild pain; Catheterization time was (29.52 ±10.28) minutes; Puncture site bleeding occurred in 5 cases; 3 cathetera were not inserted amoothly; and 9 catheters were displaced in jugular vein. Conclusion Ultrasound-guided modified Seldinger technique. applied to patients with difficultiea in placinf; PICC, improves the tuccess rate of catheterization, relieves the pain. and shonens the time of catheterization , so it is worthy of clinical application.%目的:探讨超声引导下改良塞丁格穿刺法(modified seldinger technique,MST)在经外周静脉置人中心静脉导管(peripherally inserted central catheters,PICC)置管困难患者中的应用效果.方法:选择本院2009年12月-2010年12月收治的69例置管困难患者,经视觉和手的触觉无法找到可穿刺的血管,采用超声引导下MST进行PICC置管,观察置管的效果.结果:患者置管成功率100.00%;置管时疼痛评分1-3分,平均(1.35±0.64)分,为轻度疼痛;置管时间18-60min,平均(29.52±10.28)min;并发症情况:发生穿刺点出血5例,送管不顺利3例,导管异位至颈静脉9例.结论:超声引导下MST应用于PICC置管困难的患者,能提高患者的置管成功率,减轻患者置管时疼痛,缩短置管时间,值得临床推广应用.