[1]陈雅玫 石新华 张煜﹡.超声引导下改良Seldinger技术与盲穿法行PICC在肿瘤患者中的对比研究[J].中国微创外科杂志,2013,13(12):1131-1144.
　Chen Yamei,Shi Xinhua,Zhang Yu..Comparative Study of Ultrasoundguided Modified Seldinger Technique and Blind Insertion for Peripherally Inserted Central Catheters (PICC) in Cancer Patients[J].Chinese Journal of Minimally Invasive Surgery,2013,13(12):1131-1144.
点击复制

超声引导下改良Seldinger技术与盲穿法行PICC在肿瘤患者中的对比研究()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
13
期数:
2013年12期
页码:
1131-1144
栏目:
论著
出版日期:
2013-12-20

文章信息/Info

Title:
Comparative Study of Ultrasoundguided Modified Seldinger Technique and Blind Insertion for Peripherally Inserted Central Catheters (PICC) in Cancer Patients
作者:
陈雅玫 石新华 张煜﹡
北京大学第三医院肿瘤科，北京100191
Author(s):
Chen Yamei; Shi Xinhua;  Zhang Yu.
Department of Oncology, Peking University Third Hospital， Beijing 100191, China
关键词:
改良Seldinger技术; 外周静脉置入中心静脉导管; 超声引导
Keywords:
Modified Seldinger technique; Peripheral inserted central venous catheter (PICC); Ultrasoundguided
分类号:
R730.5
文献标志码:
A
摘要:
目的探讨超声引导下改良Seldinger技术行外周静脉置入中心静脉导管(peripheral inserted central venous catheter, PICC)的价值。方法2011年1月~2013年3月对213例肿瘤患者采用超声引导下改良Seldinger技术行PICC(超声引导组)，与采用盲穿法的230例肿瘤患者(盲穿组)进行对比，比较2组PICC穿刺置管成功率及相关并发症。结果超声引导组一次性穿刺成功率95.3%(203/213)，显著高于盲穿组78.3%（180/230）（χ2=27.436，P=0.000），一次性置管成功率98.1%(209/213)，显著高于盲穿组78.3%（180/230）（χ2=40.755，P=0.000）。超声引导组血栓性静脉炎发生率为05%（1/212），显著低于盲穿组4.5%（9/202）（χ2=5.377，P=0.020）；机械性静脉炎发生率0.9%（2/212），显著低于盲穿组7.9%（16/202）（χ2=12.109，P=0.001）。超声引导组无一例发生导管相关性感染，盲穿组1例，2组比较无统计学差异（Fisher’s检验，P=0.488）。结论超声引导下改良Seldinger技术对肿瘤患者行PICC比盲穿法可以显著提高穿刺置管成功率，并发症少，安全有效。
Abstract:
ObjectiveTo investigate the clinical value of ultrasoundguided modified Seldinger technique for PICC in cancer patients.MethodsFrom January 2011 to March 2013, ultrasoundguided modified Seldinger technique for PICC was applied in 213 cases of cancer patients (ultrasoundguided group), while blind insertion was applied in 230 cases of cancer patients (blind insertion group). The puncture and catheterization success rate and related complications were compared between the two groups.ResultsThe puncture success rate of ultrasoundguided group was 95.3% (203/213), significantly higher than that of blind insertion group (78.3%,180/230; χ2=27.436,P=0.000); catheterization success rate of ultrasoundguided group was 98.1% (209/213), significantly higher than that of blind insertion group (78.3%,180/230; χ2=40.755,P=0.000); thrombophlebitis rate of ultrasoundguided group was 0.5% (1/212)，significantly lower than that of blind insertion group (4.5%,9/202; χ2=5.377，P=0020); mechanical phlebitis rate of ultrasoundguided group was 0.9% (2/212), significantly lower than that of blind insertion group (79%,16/202; χ2=12.109, P=0.001). No patient in ultrasoundguided group developed catheterrelated infection while only one patient (0.5%, 1/212) in blind insertion group developed catheterrelated infection,and no significant difference was found between the two groups (Fisher’s Exact Test,P=0.488).ConclusionsThe application of ultrasoundguided modified Seldinger technique for PICC in cancer patients significantly increases puncture and catheterization success rate, and causes few complications. The procedure is safe and effective for cancer patients.

参考文献/References:

[1]McMahon DD．Evaluation new technology to improve patient outcomes：a quality improvement approach．J Infus Nurs,2002,25(4):250-255.
[2]Robinson MK，Mogensen KM，Grudinskas GF, et al．Improved care and reduced costs for patients requiring peripherally inserted central catheters：the role of bedside ultrasound and a dedicated team．J Parenter Enteral Nutr,2005,29(5):374-379.
[3]Yaghmai B，Owens CA，Warner D．Peripherally inserted central catheters．Semin Intervent Radiol,1998,15(3):305-314.
[4]Sofocleous CT．Sonographically guided placement of peripherally inserted central catheters：review of 355 procedures． Am J Roentgenol,1998,170(6):1613-1616.
[5]Chrisman HB，Omary RA，Nemacek AA，et a1．Peripherally inserted central catheters：guidance with use of US versus venography in 2650 patients．J Vasc Interv Radiol,1999,10:473-475.
[6]刘聿秀，高玉芳，王秀荣，等.B超引导下改良Seldinger技术在PICC置管中的应用.山东医药，2010,50(3):99-100.
[7]周薇，刘丽兰，何佩仪，等.超声引导下经外周置人中心静脉导管的效果观察.护理学报，2011,18(1B):53-55.
[8]Chopra V, Anand S, Hickner A, et al. Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and metaanalysis. Lancet,2013,13:60592-60599.
[9]Pongruangporn M, Ajenjo MC, Russo AJ, et al. Patientand devicespecific risk factors for peripherally inserted central venous catheterrelated bloodstream infections. Infect Control Hosp Epidemiol,2013,34(2):184-189.
[10]黄敏，王国蓉，江群，等.超声引导下改良赛丁格穿刺技术对PICC导管使用效果的影响.肿瘤预防与治理，2012,25（2）：108-111.
[11]刘为红，闻摇曲，鲍爱琴，等.运用改良塞丁格技术行PICC肘上置管的效果观察.护理研究，2010,2（6）：1670-1671.

备注/Memo

备注/Memo:
﹡通讯作者,Email:dentdoctor@sohu.com
更新日期/Last Update: 2014-11-04