中华护理杂志
中華護理雜誌
중화호리잡지
CHINESE JOURNAL OF NURSING
2010年
1期
26-28
,共3页
冯毕龙%姚述远%周素军%覃慧敏
馮畢龍%姚述遠%週素軍%覃慧敏
풍필룡%요술원%주소군%담혜민
导管插入术%中心静脉%监测%生理学%静脉%心电描记术
導管插入術%中心靜脈%鑑測%生理學%靜脈%心電描記術
도관삽입술%중심정맥%감측%생이학%정맥%심전묘기술
Catheterization%Central Venous%Monitoring%Physiologic%Veins%Electrocardiography
目的 探讨经外周静脉置入中心静脉导管(PICC)时腔内心电图P波的变化及其对置管的指导作用.方法 选择因各种临床情况需置入PICC的62例患者.置入操作在X线透视下完成,同时以PICC导丝为探测电极,监测导管头端位于不同血管部位时的腔内心电图.结果 所有患者通过导丝介导均能获得腔内心电图.体表心电图P波振幅为(1.11±0.36)mm,导管头端位于腋静脉,锁骨下静脉,头臂静脉,上腔静脉的上、中、下段,右房交界处及右房中、下部时腔内心电图P波振幅分别为(1.11±0.36)mm、(1.12±0.28)mm、(1.56±0.45)mm、(4.03±1.87)mm、(5.90±2.45)mm、(7.90±2.95)mm、(9.87±2.77)mm、(5.00±1.76)mm、(2.50±1.73)mm.10例患者最初导管头端异位于颈内静脉,此时P波振幅为(1.14±0.34)mm.结论 以PICC导丝作为探测电极可引出腔内心电图,腔内心电图P波振幅与PICC头端位置有关,最大P波振幅可指导导管头端的定位.
目的 探討經外週靜脈置入中心靜脈導管(PICC)時腔內心電圖P波的變化及其對置管的指導作用.方法 選擇因各種臨床情況需置入PICC的62例患者.置入操作在X線透視下完成,同時以PICC導絲為探測電極,鑑測導管頭耑位于不同血管部位時的腔內心電圖.結果 所有患者通過導絲介導均能穫得腔內心電圖.體錶心電圖P波振幅為(1.11±0.36)mm,導管頭耑位于腋靜脈,鎖骨下靜脈,頭臂靜脈,上腔靜脈的上、中、下段,右房交界處及右房中、下部時腔內心電圖P波振幅分彆為(1.11±0.36)mm、(1.12±0.28)mm、(1.56±0.45)mm、(4.03±1.87)mm、(5.90±2.45)mm、(7.90±2.95)mm、(9.87±2.77)mm、(5.00±1.76)mm、(2.50±1.73)mm.10例患者最初導管頭耑異位于頸內靜脈,此時P波振幅為(1.14±0.34)mm.結論 以PICC導絲作為探測電極可引齣腔內心電圖,腔內心電圖P波振幅與PICC頭耑位置有關,最大P波振幅可指導導管頭耑的定位.
목적 탐토경외주정맥치입중심정맥도관(PICC)시강내심전도P파적변화급기대치관적지도작용.방법 선택인각충림상정황수치입PICC적62례환자.치입조작재X선투시하완성,동시이PICC도사위탐측전겁,감측도관두단위우불동혈관부위시적강내심전도.결과 소유환자통과도사개도균능획득강내심전도.체표심전도P파진폭위(1.11±0.36)mm,도관두단위우액정맥,쇄골하정맥,두비정맥,상강정맥적상、중、하단,우방교계처급우방중、하부시강내심전도P파진폭분별위(1.11±0.36)mm、(1.12±0.28)mm、(1.56±0.45)mm、(4.03±1.87)mm、(5.90±2.45)mm、(7.90±2.95)mm、(9.87±2.77)mm、(5.00±1.76)mm、(2.50±1.73)mm.10례환자최초도관두단이위우경내정맥,차시P파진폭위(1.14±0.34)mm.결론 이PICC도사작위탐측전겁가인출강내심전도,강내심전도P파진폭여PICC두단위치유관,최대P파진폭가지도도관두단적정위.
Objective To analyze the changes of P wave of intracavitary electrocardiogram (ECC) in the placement of periph erally inserted central venous catheters (PICC), and to explore whether the intracavitary ECG can be used to guide the procedure. Methods PICC was inserted in 62 adult patients under intracavitary ECC-guided technique. The intracavitary ECC were recorded in different parts of vessel access through micro-guidewire. Results The intracavitary ECG extracted through micro-guidewire were accurately recorded in all patients. The amplitudes of P wave were (1.11 ±0.36)mm, (1.12±0.28)mm,(1.56±0.45)mm, (4.03±1.87)mm, (5.90±2.45)mm, (7.90±2.95)mm, (9.87±2.77)mm, (5.00±1.76)mm, (2.50±1.73)mm when PICC tip was located in the axillary, subclavian and brachiocephalic vein, in the superior, middle and inferior SVC, at the SVC-right atrium junction, and in the middle, inferior right atrium,respectively. The amplitude of P wave was 1.14±0.34mm in 10 patients with PICC tip malposition in the internal jugular vein. Conclusions The intracavitary ECG can be extracted with the microguidewire of PICC system. The amplitude of P wave is related to the location of PICC tip, which can be used to guide the PICC insertion and positioning.
