CAJ | 학술논문

目的调查PICC置管时导管异位的原因和纠正方法并分析其相关因素.方法分析354例肿瘤患者行PICC置管时32例导管异位发生的相关因素,在未拔导丝前予以正位.结果导管异位发生在年龄＞ 60岁者较≤60岁者多,差异具有统计学意义(x2=4.733,P＜0.05)；87.5％发生于置管侧静脉中；左上肢置管的异位率较右上肢者高,差异具有统计学意义(x2=7.552,P＜0.01)；头静脉置管者异位率为15.79％,而肘正中静脉和贵要静脉置管者分别为8.89％和8.12％.导管异位率与患者的性别、穿刺方法及病变部位无关,差异无统计学意义(P＞0.05).32例异位者正位均获成功.结论娴熟的技术是置管成功的保证,对高龄患者置管要谨慎,尽量选择右上肢静脉置管,以贵要静脉为首选,次之为肘正中静脉.带导丝立即在X线下视导管异位的具体情况,变动患者体位并随其吸气不失时机地正位.
목적 조사PICC치관시도관이위적원인화규정방법병분석기상관인소.방법 분석354례종류환자행PICC치관시32례도관이위발생적상관인소,재미발도사전여이정위.결과 도관이위발생재년령＞ 60세자교≤60세자다,차이구유통계학의의(x2=4.733,P＜0.05)；87.5％발생우치관측정맥중；좌상지치관적이위솔교우상지자고,차이구유통계학의의(x2=7.552,P＜0.01)；두정맥치관자이위솔위15.79％,이주정중정맥화귀요정맥치관자분별위8.89％화8.12％.도관이위솔여환자적성별、천자방법급병변부위무관,차이무통계학의의(P＞0.05).32례이위자정위균획성공.결론 한숙적기술시치관성공적보증,대고령환자치관요근신,진량선택우상지정맥치관,이귀요정맥위수선,차지위주정중정맥.대도사립즉재X선하시도관이위적구체정황,변동환자체위병수기흡기불실시궤지정위.
Objective To explore the reason and remedy on tumor patients' PICC misplacement.Methods The reason of 32 tumor patients' PICC misplacement were analyzed. The patients whose PICC misplaced were observed by X-ray,and then regulated to precava before remove the wire.Results PICC misplacement was much more observed in patients who was sixty years old or above than that of their younger counterpart (x2 =4.733,P ＜0.05).87.5％ of PICC misplacement were observed in the ipsilateral vein and less observed in right upper extremity ( x2 =7.552,P =0.006).The rate of PICC misplacement of cephalic vein,median cubital vein and basilic vein respectively were 15.7％,8.89％ and 8.12％.And there was no significant difference was detected in the gender,method and the location of cancer ( P ＞ 0.05 ).Finally,all the misplacement PICC were regulated to the right place.Conclusions Adept technology makes success,and more attention should pay to elderly patients.It is better to insert PICC in patient' s right upper extremity,especially basilic vein,and then median cubital vein.Utilize the X-ray to adjust patients position,and matching inspiration to adjust PICC' s location in order to avoid misplacement.