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目的探讨心电图引导PICC尖端定位技术在血液肿瘤患儿中的临床应用效果。方法选取2014年8月—2015年3月自愿行PICC置管的血液肿瘤患儿110例,观察组55例,采用新型心电图引导PICC尖端定位技术置管;对照组55例,采用传统穿刺法置管。观察组导管尖端位置和方向的确定依据ECGⅡ导联P波的变化,记录置管到位率及长度。两组导管固定后均行X线检查(胸部正位片)确定导管尖端位置。比较两组导管尖端位置及并发症发生率。结果对照组患儿导管异位发生率高于观察组患儿,两组比较差异有统计学意义(P<0.05);观察组患儿PICC导管尖端位置位于上腔静脉与右心房交汇处的准确率优于对照组患儿,两组比较差异有统计学意义(P<0.05)。结论心电图引导PICC尖端定位技术应用于血液肿瘤患儿置管中具有较高的准确性及安全性,值得在临床中推广。
Objective To investigate the clinical application of electrocardiogram-guided PICC tip-positioning technique in children with hematological malignancies. Methods From August 2014 to March 2015, 110 children with hematologic malignancies who underwent PICC catheterization voluntarily and 55 patients in observation group were enrolled in this study. They were guided by a new electrocardiogram (PICC) technique. In the control group, 55 patients were treated by traditional puncture method tube. The observation group catheter tip position and direction of the determination based on ECG Ⅱ lead P wave changes recorded catheter arrival rate and length. X-ray examination (chest anteroposterior) was performed after both catheters were fixed to determine the catheter tip position. The catheter tip position and complication rate were compared between the two groups. Results The incidence of ectopic catheter in children in the control group was significantly higher than that in the observation group (P <0.05). The location of the PICC catheter tip in the observation group was located at the intersection of the superior vena cava and the right atrium Rate was better than control group, the difference between the two groups was statistically significant (P <0.05). Conclusion Electrocardiogram-guided PICC tip localization technique has the advantages of high accuracy and safety in catheterization of children with hematological malignancies, and is worthy of promotion in clinical practice.