摘要
目的探讨超声和超声造影(contrast enhanced ultrasound,CEUS)技术在确认带隧道和涤纶套的导管(tunneled cuffed catheter,TCC)尖端的位置的作用。方法对45例透析患者根据传统体表定位法和Seldinger法,在超声实时引导下穿刺,置入TCC导管。术后常规超声剑突下心腔四切面直接观察导管尖端位置。对于不能确认管尖位置的则进行导管内CEUS再次确认。对于导管尖端未达目标位置,即时调整导管尖端至目标位置。术毕行胸片检查作对比。结果常规超声导管尖端识别率77.8%(35/45例),剩余10例行CEUS,识别率提高至100%。导管尖端一次性到达目标位置比率(62.2%),剩余需要重新调整管尖位置。结论超声或CEUS可实时确定导管尖端位置,从而达到精确放置TCC导管的效果。本法具有安全、快速、准确、方便和无辐射等优点,值得推广。
Objective To explore the usefulness of conventional ultrasonography and contrast enhanced ultrasonography（CEUS） to identify the tip position of tunneled cuffed catheter（TCC）. Methods A total of 45 patients were subjected to TCC placement under the guidance of body landmark and Seldinger＇s techniques and beside real-time ultrasonography. After insertion of the catheter, conventional ultrasonography via subxiphoid cardiac view was used to observe the tip position. If the catheter tip was not visible on conventional ultrasonography, CEUS was performed to further confirm the catheter tip position. If the catheter tip was not in its target position, prompt adjustment was made. After the manipulation, a chest radiograph was made to reconfirm the tip positioning. Results Conventional ultrasonography identified the catheter tips in 77.8%（35/45） patients, and CEUS identified the tip position in the remaining 10 patients. Only 62.2% catheter tips located at the target position at the first attempt, and adjustment of the catheter tips was required in the remaining patients. Conclusions Conventional ultrasonography combined with CEUS can accurately and promptly identify the tip position of TCC. This method is safe, accurate, time-saving, convenient and free of radiation.We recommend its use following TCC insertion.
出处
《中国血液净化》
2017年第3期201-203,共3页
Chinese Journal of Blood Purification
基金
湖北省卫生和计划生育委员会资助项目WJ2015MB271
关键词
超声造影
带隧道和涤纶套的导管
尖端位置
Contrast enhanced ultrasonography
Tunneled cuffed catheter
Tip position
