论文部分内容阅读
目的探讨经外周静脉置入中心静脉导管(PICC)置管时导管头端多次异位到颈内静脉时的有效复位方法。方法收集2014年3月-12月在血管超声引导下行PICC置管时,导管头端异位到颈内静脉3次以上的患者17例,对其首先按常规复位法复位3次,仍不能成功复位,则采用支撑导丝头端退出法,以利用血液流向和重力作用,将异位的导管调整至正常位置。结果 17例患者先采用常规复位法复位3次,均不成功。改用支撑导丝头端退出法进行复位,一次复位成功16例,成功率为94.11%;二次复位成功率达100%。结论 PICC置管联合血管超声,能及时发现导管是否异位颈内静脉,采用常规复位方法 3次,均不能成功复位时,采用支撑导丝头端退出法,可有效纠正导管头端异位,提高置管成功率,减少反复送管所致静脉并发症。
Objective To investigate the effective reduction of catheter tip multiple endotracheal to the internal jugular vein when inserted into the central venous catheter (PICC) through the peripheral vein. Methods From March to December 2014, 17 patients with ectopic endoscopic catheterization of the catheter to the internal jugular vein during PICC catheterization were retrospectively analyzed. In the first instance, 17 patients underwent three-step reduction by conventional reduction method and were still unsuccessful Reset, then use the guide wire tip exit method to take advantage of the blood flow and gravity, the ectopic catheter to adjust to the normal position. Results 17 patients were treated with conventional reduction and then reset 3 times without success. Instead, the guidewire tip was withdrawn and used for reduction. One successful reduction was performed in 16 cases, with a success rate of 94.11%. The success rate of secondary reduction was 100%. Conclusion PICC catheter combined with vascular ultrasound, catheter can be found in time whether the ectopic jugular vein, using conventional reduction method 3 times, can not be successfully reset, the use of support guide wire tip withdrawal method, which can effectively correct the catheter tip ectopic, Improve the success rate of catheter, reduce the recurrence of venous complications caused by catheter.