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目的探讨乳腺癌患者经外周静脉置入中心静脉导管(peripherally inserted central catheters PICC)异位的复位处理方法及防范对策。方法对2011年1月—2013年7月共176例乳腺癌PICC置管患者发生导管异位情况进行回顾性分析,比较不同静脉置管异位的发生率及复位处理方法。结果17例中19例发生导管异位,发生率为10.8%。贵要静脉、肘正中静脉、头静脉间比较异位发生率差异有统计学意义(P<0.05),其中经头静脉置管发生异位的几率最高。根据异位情况采取不同的复位方法,如拔出部分导管﹑退管后在送管复位等。19例导管异位患者18例正位成功,复位成功率为95%。结论乳腺癌患者PICC置管应选择异位发生率低的粗﹑直﹑静脉瓣少的贵要静脉,尽量避免头静脉或走向头静脉的正中静脉置管,必须在头静脉置管且发生异位时需采取科学的复位方法,避免盲目的退管或送管。
Objective To investigate the treatment of ectopic posterior displacement of peripherally inserted central catheters (PICC) in patients with breast cancer and its preventive measures. Methods A retrospective analysis of 176 patients with PICC in patients with breast cancer from January 2011 to July 2013 was performed. The incidence of ectopic catheterization and the treatment of resetting were compared. Results Of 17 cases, 19 cases had ectopic catheterization, the incidence was 10.8%. There were significant differences in the incidence of ectopic between the VIP vein, median elbow vein and head vein (P <0.05), and the highest incidence of EOC occurred in the catheter. Depending on the ectopic situation to take a different reset method, such as pulling out part of the catheter, after the withdrawal of the tube in the reset and so on. Twenty-nine patients with ectopic catheter were successfully treated with 95% reduction. Conclusion PICC catheter in patients with breast cancer should choose the crude ectopic low incidence of crude ﹑ ﹑ less expensive venous vein, try to avoid the cephalic vein or toward the cephalic vein of the median vein catheter must be catheterized and the occurrence of different Need to take a scientific reset method, to avoid blind retreat or to send.