CAJ | 학술논문

目的：探讨超声引导联合塞丁格技术在经外周置入中心静脉导管（peripherally inserted central catheter，PICC）置管中的应用效果。方法将1008例需行PICC置管的恶性肿瘤患者,根据肘部血管条件，良好者（即直视或可触及有弹性的肘部静脉）作为对照组（540例），差者﹙即直视或触摸不到肘部静脉﹚为实验组（468例）。对照组患者按常规在肘部静脉置入PICC导管，实验组患者通过贵要静脉或肱静脉在超声引导联合塞丁格技术下置入PICC导管。比较两组患者一次穿刺成功率、一次置管成功率及术后机械性静脉炎、静脉血栓、导管相关性感染发生率。结果两组患者一次穿刺成功率比较， P＞0.05，差异无统计学意义，但实验组一次性置管成功率明显高于对照组，置管后机械性静脉炎、静脉血栓、导管相关性感染发生率明显低于对照组，两组比较，均P<0.001，差异具有统计学意义。结论超声引导结合赛丁格技术行PICC置管成功率高，术后并发症少，安全性高。
목적：탐토초성인도연합새정격기술재경외주치입중심정맥도관（peripherally inserted central catheter，PICC）치관중적응용효과。방법장1008례수행PICC치관적악성종류환자,근거주부혈관조건，량호자（즉직시혹가촉급유탄성적주부정맥）작위대조조（540례），차자﹙즉직시혹촉모불도주부정맥﹚위실험조（468례）。대조조환자안상규재주부정맥치입PICC도관，실험조환자통과귀요정맥혹굉정맥재초성인도연합새정격기술하치입PICC도관。비교량조환자일차천자성공솔、일차치관성공솔급술후궤계성정맥염、정맥혈전、도관상관성감염발생솔。결과량조환자일차천자성공솔비교， P＞0.05，차이무통계학의의，단실험조일차성치관성공솔명현고우대조조，치관후궤계성정맥염、정맥혈전、도관상관성감염발생솔명현저우대조조，량조비교，균P<0.001，차이구유통계학의의。결론초성인도결합새정격기술행PICC치관성공솔고，술후병발증소，안전성고。
Objective To investigate the effect of ultrasound technology combined with Seldinger technique in the catheteration of peripherally inserted central catheter(PICC).Methods One thousand and eight malignant tumor patients undergoing PICC catheteration were divided into two groups:those with visible or palpable bouncy vein as the control group(n=540)and those with invisible or impalpable elbow vein as the experiment group(n=468).The control group were treated with PICC catheteration into the elbow vein as normal control group and in the experiment group the catheteration was done into the lower part of the upper arm of the basilic vein or brachial vein as the puncture point under the guidance of ultrasound with Seldinger technique.The two groups were compared in terms of success rate of one time puncturing, success rate of one time catheterization and postoperative phlebitis,venous thrombosis and catheter related infection rate.Result There were no significant difference in the success rate for one time puncturing,while the success rate of one time catheterization in the experiment group was significantly higher than that in the control group and the mechanical phlebitis,venous thrombosis,catheter related infection rate in the experiment group were significantly lower than those in the control group(P<0.001).Conclusion Ultrasound technology combined with Seldinger technique for PICC catheterization can obtain high success rate,lower postoperative complications and provide high security.