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预防PICC置管时异位入颈内静脉的改进方法

         

摘要

Objective:To explore the effective method of preventing tube ectopic into the internal jugular vein for Peripherally inserted central catheters ( PICC) . Methods:160 patients with PICC were randomly divided into the control group and experimental group,80 cases of each group. In the control group,a position of 90° abduction was adopted between upper limb and the trunk,when the catheter tip reached the shoulders,the patients were turned over with their heads to the side. While in the experimental group,the catheter was shaping before intubation,and the patients raise their arms and close the heads to the upper limbs when the catheter tip reached the shoulders. After catheter,the comparison was made with the incidence of catheter ectopic. Results:The incidence of catheter heterotopia in experimental group was significantly lower than that of the control group (P<0. 05). Conclusion:It can reduce the inci-dence of heterotopia into the internal jugular vein catheter with shaping the catheter before intubation,and raise the patients′arms and close their heads to the upper limbs when the catheter tip reached the shoulders. It is worthy of clinical application.%目的::探讨经外周置入中心静脉导管( PICC)置管时预防导管异位入颈内静脉的有效方法。方法:将2012年10月~2014年3月我院160例行PICC置管患者随机等分为对照组和试验组,对照组采用常规的患者上肢外展与躯干呈90°体位,当导管头端到达肩部时采用偏头法;试验组送管前对导管进行塑形、当导管头端送至肩峰时再采用举臂贴头体位。置管后比较导管异位入颈内静脉的发生率。结果:试验组导管异位入颈内静脉的发生率明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论:在PICC置管时采用对导管塑形和举臂贴头法能明显降低导管异位入颈内静脉的发生率,值得临床推广应用。

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