摘要
目的比较在Ｘ线辅助下经外周静脉至中心静脉置管（ｐｅｒｉｐｈｅｒａｌｙｉｎｓｅｒｔｅｄｃｅｎｔｒａｌｃａｔｈｅｔｅｒ，ＰＩＣＣ）与传统的经锁骨下静脉至中心静脉置管（ｃｅｎｔｒａｌｖｅｎｏｕｓｃａｔｈｅｔｅｒ，ＣＶＣ）两种方法的优越性及并发症。方法自１９９７年１月至１９９８年１２月期间，在Ｘ线监视下，对ＰＩＣＣ和ＣＶＣ各６０例病人进行临床研究，观察指标包括置管成功率、导管尖端的位置、并发症发生率。两组结果经显著性检验比较。结果经Ｘ线影像证实，ＰＩＣＣ与ＣＶＣ组一次穿刺置管成功率分别为９５．０％（５７／６０例）和８８．３％（５３／６０例），ｔ＝１．７４５，Ｐ＝０．１９；置管时间平均分别为１３天（６～９８天）和１４天（７～１０４天），Ｆ＝０．０４９，Ｐ＝０．８３；导管总阻塞率分别为６．７％（４／６０例）和５．０％（３／６０例），ｔ＝０．１５２，Ｐ＝０．７０；其中ＰＩＣＣ组３Ｆｒ型导管（２０Ｇ穿刺针）阻塞率（３／２０例，１５．０％）高于４Ｆｒ型导管（１８Ｇ穿刺针）（１／２０例，５．０％），ｔ＝１．１１１，Ｐ＝０．２９；导管尖端异位率分别为５．０％（３／６０例）和６．７％（４／６０例），ｔ＝０．１５２，Ｐ＝０．７０，但?
Objective To study the feasibility, complications, mid and longterm advantages of peripherally inserted central catheters (PICC) compared with central venous access assisted with Xray. Methods From Jan 1997 to Dec 1998, we conducted a study in 60 patients with placed PICC lines and 60 patients with central lines. Study variables included tip placement and complication rates. Results Tere were on significant differences between PICC and CVC in the successful placement 95.0% and 88.3%,t=1.745, P=0.19; the mean duration 13 (6-98)days and 14 (7-104) days, F=0.049, P=0.83;the total occlusion rate 6.7% (4/60) and 5.0% (3/60), t=0.152, P=0.70. In PICC patients,the occlusion rate was slightly higher in 3 Fr (20gauge) catheter (3/20, 15.0%) than in 4 Fr(18gauge) catheters (1/20, 5.0%), t=1.111, P=0.29. Phlebitis occurred in 5.0% of patients (3/60) and one catheter fracture was happened on the catheterhub junction(1.7%). In 3 catheter tips dislocation cases, the catheter tips were moved to the optional position assisted with Xray image. In CVC group, pneumothorax happened in 1 case (1.7%). In 4 catheter dislocation cases, the catheters were with drawn. No catheterrelated sepsis and hemopneumothorax happened in both group patients. Conclusions Both PICC and CVC can be acceptable in clinical use. PICC assisted with Xray possesses the advantages of less trauma, accurate localization preventing some possible severe complications of central venous access such as pneumothorax. The new method provides a reliable, effective venous access for midand longterm usage in patients receiving a variety of solutions, primarily parenteral alimentation, chemotherapy or antibiotic infusion.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
1999年第6期378-380,共3页
Chinese Journal of Radiology
