Objective:To investigate PICC catheter tip is placed to explore the best method of in vitro in vivo measurement of the optimum position .Methods:Routine PICC catheter 186 patients were randomly divided into A,B groups.Group A modified in vitro measurements,from upper right chest puncture point to lock the joints +5 cm,group B from the puncture point to the right chest acromioclavicular joint,and then fold down to third intercostal space measure-ments.After reaching the measuring tube length,chest X -ray positioning.Compared PICC catheter tip placed into the superior vena cava and the success rate of the optimum position.Results:Group A into the superior vena cava 88 cases,85 cases placed in the optimum position;group B into the superior vena cava 67 cases,50 cases placed in the optimum position,the difference was statistically significant (P <0.05).Conclusion:The modified method of in vitro measurements,from the upper right chest clavicular joint puncture to +5 cm accurate measurement method is simple,and catheter and placed in a higher success rate optimum position.%目的：探讨 PICC 导管末端置于体内最适位置的最佳体外测量方法。方法：将186例行 PICC 置管患者随机等分为 A、B 两组。 A 组采用改良体外测量法，即从上肢穿刺点至右胸锁关节＋5 cm，B 组采用从穿刺点至右胸锁关节，再向下反折至第3肋间的测量法。置管到达测量长度后，胸部 X 线片定位。比较两组 PICC 导管末端置入上腔静脉及置于最适位置的成功率。结果：A 组置入上腔静脉88例，置入最适位置85例；B 组置入上腔静脉67例，置入最适位置50例，两组比较差异均有统计学意义（P ＜0．05）。结论：采用改良体外测量法，即从上肢穿刺点至右胸锁关节＋5 cm 的测量方法准确简便，且置管成功及置入最适位置率较高。
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