摘要
目的探讨B超引导下中心静脉导管(PICC)置管中的改良送鞘技术在血小板低下患者中的应用效果。方法选择2019年6月—2020年6月在上饶市人民医院血液科行B超引导下PICC置管的81例血小板低下患者作为研究对象,按随机数字表法分为传统组(41例)和改良组(40例)。改良组使用改良送鞘方法进行扩皮,传统组使用传统手术刀进行扩皮。比较两组的置管情况(一次性置管成功率、送鞘完成时间、扩皮送鞘后即刻出血量、置管即刻疼痛评分)和置管后情况(置管96 h内换药次数、并发症发生情况)。结果两组的一次性置管成功率比较,差异无统计学意义(P>0.05)。改良组送鞘完成时间短于传统组,扩皮送鞘后即刻出血量少于传统组,置管即刻疼痛评分低于传统组,差异有统计学意义(P<0.05)。改良组置管96 h内换药次数少于传统组;渗血、渗液、穿刺点感染发生率低于传统组,差异有统计学意义(P<0.05)。结论对血小板低下患者使用B超引导下改良送鞘技术实施PICC置管的一次性置管成功率与传统手术刀扩皮相当,而改良送鞘技术可缩短送鞘完成时间,减少置管后换药次数、扩皮送鞘后即刻出血量,减轻置管即刻疼痛程度,安全性更高。
Objective To explore the application effect of improved sheath delivery technology in peripherally inserted central catheter(PICC)placement under ultrasound B guidance in patients with thrombocytopenia.Methods From June 2019 to June 2020,a total of 81 patients with thrombocytopenia who underwent PICC catheterization under the guidance of B-ultrasound in the Department of Hematology of Shangrao People′s Hospital were selected as research subjects.According to the random number table,they were divided into a traditional group with 41 cases and a modified group with 40 cases.The modified group used a modified sheath delivery method to expand the skin,and the traditional group used a traditional scalpel to expand the skin.Catheterization conditions of the two groups including the success rate of one-time catheterization,completion time of delivery of the sheath,blood loss immediately after the expansion of the skin and delivery of the sheath,the score of pain immediately after catheterization and the post-intubation conditions were compared.In addition,including the number of dressing changes within 96 hours of catheter placement and the occurrence of complications.Results There was no statistically significant difference in the success rate of one-time catheterization between the two groups(P>0.05).The delivery time of the modified group was shorter than that of the traditional group,the difference was statistically significant(P<0.05).The blood loss immediately after the expansion and delivery of the sheath was less than that of the traditional group,the difference was statistically significant(P<0.05).The pain score was lower than that of the traditional group,and the differences were statistically significant(P<0.05).The number of dressing changes within 96 hours of catheter placement in the modified group was less than that of the traditional group,and the incidence of bleeding,exudation,and puncture point infections were lower than that of the traditional group,the difference was statistically significant(P<0
作者
江泽仙
吴春羚
方晶
沈佳坤
马慧
JIANG Ze-xian;WU Chun-ling;FANG Jing;SHEN Jia-kun;MA Hui(Department of Hematology,Shangrao People′s Hospital,Jiangxi Province,Shangrao 334000,China)
出处
《中国当代医药》
CAS
2021年第25期59-62,共4页
China Modern Medicine
基金
江西省上饶市科学技术局科技指导计划项目(20201CKJ07)。
关键词
血小板低下
改良送鞘技术
B超
中心静脉导管置管
Thrombocytopenia
Improved sheath delivery technology
B-ultrasound
Peripherally inserted central catheter
