采用9号头皮针经颈内静脉置入隧道式经外周置入中心静脉导管的应用效果

Application effect of peripherally inserted central catheter by tunneling through the internal jugular vein with No.9 scalp needle

  • 摘要:
      目的  观察采用9号头皮针经颈内静脉置入隧道式经外周置入中心静脉导管(PICC)的临床效果。
      方法  选取接受中心静脉置管建立静脉通路的60例患者作为研究对象,采用随机数字表法分为对照组和实验组,每组30例。对照组采用盲穿法锁骨下静脉置入中心静脉导管(CVC)术,实验组采用超声引导下的9号头皮针经颈内静脉置入隧道式PICC术,比较2组一针穿刺成功率、操作痛发生情况、置管时间、非计划拔管发生率和相关并发症发生率。
      结果  实验组的一针穿刺成功率高于对照组,操作痛评分和非计划拔管发生率低于对照组,置管时间长于对照组,差异有统计学意义(P < 0.05);2组渗血程度比较,差异无统计学意义(P>0.05);实验组导管相关性感染、导管移位和导管堵塞发生率均低于对照组,差异有统计学意义(P < 0.05)。
      结论  采用9号头皮针经颈内静脉穿刺置入隧道式PICC,能够降低导管相关感染发生率,延长导管留置时间,为双上肢PICC置管受限的患者提供了一种安全、经济、有效的静脉通路。

     

    Abstract:
      Objective  To observe the clinical effect of peripherally inserted central catheter(PICC) by tunneling through the internal jugular vein with No.9 scalp needle.
      Methods  Sixty patients who received PICC to establish venous access were selected as research objects, and were divided into control group and experimental group by random number table method, with 30 cases in each group. In the control group, central venous catheter (CVC) was inserted through the subclavian vein, while in the experimental group, tunnel PICC was inserted through the internal jugular vein with No.9 scalp needle under ultrasonic guidance. The success rate of one-time puncture and operation pain, catheter indwelling time, incidence rate of the unplanned extubation and related complications were compared.
      Results  The success rate of one-time puncture of the experimental group was higher, operation pain score and unplanned extubation rate of the experimental group were significantly lower than those of the control group, catheter indwelling time was longer than that of the control group(P < 0.05). There was no significant difference in the degree of bleeding between the two groups (P>0.05). The incidence rates of catheter-related infection, catheter displacement and catheter blockage in the experimental group were lower than those in the control group (P < 0.05).
      Conclusion  No.9 scalp needle can reduce catheter-related infection, prolong catheter indwelling time, and provide a safe, economic and effective venous access for patients with PICC by tunneling through the internal jugular vein.

     

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