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目的探讨导管漂浮原理预防经外周中心静脉置管异位的临床应用价值。方法随机选取在2012年2月~2015年12月在我院接收治疗的进行经外周中心静脉置管(PICC)的患者210例作为研究对象,将其分为观察组和对照组。所有的患者均选择超声实时和体表定位进行观察,确认导管进入锁骨下静脉后,观察组将导管和导丝从末端进行分离,然后撤出导丝(3 cm),送至预测量的长度;对照组选择传统的方法进行PICC的置入,比较两组患者的颈内静脉异位率。结果观察组无颈内静脉异位,对照组患者中有15例,导管异位发生率为18.75%,差异有统计学意义(P<0.01)。结论 PICC置入的首选静脉是贵要静脉,在贵要静脉中最常见的异位为颈内静脉异位,因此降低患者的颈内静脉异位的发生率可有效降低PICC置管异位相关并发症,值得推广。
Objective To investigate the clinical value of catheter floating principle in preventing peripheral ectopic catheterization. Methods Totally 210 patients who underwent percutaneous central venous catheterization (PICC) who received treatment in our hospital from February 2012 to December 2015 were randomly selected as the study group, which were divided into observation group and control group. All patients were selected ultrasound real-time and surface positioning to observe, confirm the catheter into the subclavian vein, the observation group catheter and guide wire from the end of the separation, and then withdraw the guide wire (3 cm), to the pre-measured length ; Control group choose the traditional method of PICC placement, compared two groups of patients with internal jugular venous heterotopic rate. Results The observation group had no ectopic endogastric vein. There were 15 cases in the control group and the ectopic catheterization rate was 18.75%, the difference was statistically significant (P <0.01). CONCLUSIONS: The preferred vein for PICC implantation is the dominating vein, and the most common ectopic in the essential vein is the ectopia of the internal jugular vein. Therefore, reducing the incidence of ectopic endodermis in patients with PICC can effectively reduce the risk of ectopic pregnancy Complications, worth promoting.