摘要
目的 研究右侧第6、7后肋间隙、右侧第6后肋、右侧第7后肋与上腔静脉入右心房口（CAJ）的位置关系,分析其作为PICC术后导管头端定位标志临床应用价值。方法 胸部16排CT平扫的体检者213例,以CT定位相作为模拟X线平片,通过CT图像测量右侧第6、7后肋间隙、右侧第6后肋、右侧第7后肋至CAJ的距离,采用统计学方法分析各影像解剖结构与CAJ的位置关系及其作为PICC定位标志的有效性和安全性。结果 右侧第6、7后肋间隙、右侧第6后肋、右侧第7后肋至CAJ的距离分别为（19.446±14.4981）mm、（28.232±16.7217）mm、（13.741±11.1473）mm,各组间对比存在统计学差异（2=93.793,P=0.000）;实测距离分析,位于0~20mm理想位置和〈0mm危险位置者所占比例分别为45.5%、14.6%,31.9%、4.2%,43.2%、39.4%,各组资料间存在统计学差异（2=11.040,P=0.000）。结论右侧第7后肋至CAJ的距离最近且波动性最小,但作为PICC置管定位标志安全性较低,综合比较右侧第6、7后肋间隙作为PICC术后胸片上导管头端定位标志为宜。
Objective To find the best positioning reference point in the chest photography after PICC replacement by measur- ing CT images. Methods From January 2015 to June 2015, the physical examination data of 213 cases with chest CT examina- tion were collected to measure and analyze the lengths from the intercostal space between the 6 th and 7 th posterior fib, the 6 th right posterior fib, the 7 th right posterior fib to Cavoatrial junction（CAJ）. Results The lengths from the intercostal space be- tween the 6 th and 7 th posterior fib, the 6 th right posterior fib, the 7 th right posterior fib to CAJ were （ 19. 446 ± 14. 4981 ） ram, （28.232 ± 16. 7217） ram, （13. 741 ± 11. 1473） ram, the difference had statistically significant （Z2 = 93. 793, P = 0. 000）. In the four groups, the percent of cases, whose lengths were 0 - 20 ram, were 45.5% , 31.9% , 43.2% , and the per- cent of cases, whose lengths were 〈 0 ram, were 14.6% , 4.2% , 39.4% , the difference had statistically significant （ Z2 = 11. 040, P = 0. 000）. Conclusion The intercostal space between the 6 th and 7 th posterior fib is the better choice than the 6 th right posterior fib and the 7 th right posterior fib as the positioning reference point after PICC replacement.
出处
《医学影像学杂志》
2016年第9期1612-1615,共4页
Journal of Medical Imaging
关键词
肋间隙
后肋
上腔静脉入右心房口
经外周置入中心静脉导管
定位
体层摄影术
X线计算机
Intercostal space
The posterior fib
Cavoatrial junction
Peripherally inserted central catheter
Positioning refer- ence point
Tomography, X-ray computed
