摘要
目的:探讨自制心电连接器在经外周穿刺中心静脉导管(peripherally inserted central catheter,PICC)置管尖端定位中的应用。方法:选取2017年1-12月本院接受PICC的患者60例。在对患者成功导管穿刺之后,对其采用心电定位技术实施PICC尖端定位,之后进行X线胸片检查,与其结果进行比较。观察自制心电连接器在PICC置管尖端定位中的应用效果。结果:患者均实施了PICC置管,穿刺后进行X线胸片检查发现患者导管头端均位于上腔静脉(SVC),55例心电图出现特征性P波,5例未出现P波变化,在及时进行导管调整之后,4例患者均出现P波特异性变化,1例未出现。自制心电连接器的特征性P波对导管头端位置在SVC中的灵敏度为100%(59/59),特异度为0。PICC头端处于最佳位置时的导管长度与P波位于峰值时的导管长度的差值为(2.8±0.7)cm。结论:自制心电连接转换器使用效果明显,在临床治疗过程中的效果与专业心内连接器相当,能够采用心房内心电图(ECG)Ⅱ导联P波的形式,明确PICC尖端位置,且无需要求较高的材料和制作手段,制作过程简单,取材便捷,在为患者进行临床治疗时具有较高的使用价值。
Objective：To explore the application of self-made electrocardiogram connector in peripherally inserted central catheter（PICC） catheter tip location.Method：A total of 60 patients received PICC in our hospital from January to December 2017 were selected.After successful catheterization,the PICC tip location was carried out by electrocardiographic localization.After that,chest X-ray examination was performed and compared with the results.The application effect of the self-made electrocardiogram connector in the position of the PICC tube tip were observed.Result：PICC catheterization was performed in all patients.The chest X-ray examination after the puncture showed that the end of the catheter was located in the superior vena cava（SVC）,55 cases had the characteristic P wave in the electrocardiogram,and there were no changes in the P wave in 5 cases,but after the timely adjustment of the catheter,4 patients had the characteristic P wave,1 case did not appear.The sensitivity of the characteristic P wave of the self-made electrocardiogram connector to the head end of the catheter in SVC was 100%（59/59）,and the specificity was 0.The difference between the length of the catheter at the best position at the head of PICC and the length of the catheter at the peak of the P wave was（2.8±0.7） cm.Conclusion：The effect of the selfmade electrocardiogram connection converter is obvious,and the effect in process of clinical treatment is equivalent to that of the professional inner connector,can adopt intra-atrial electrocardiogram（ECG） lead Ⅱ P wave,clear PICC tip position,and without the need for higher material and production methods,process simple,convenient material,high in clinical treatment for patients with use value.
作者
李迎
LI Ying(Jingdezhen First People’s Hospital,Jingdezhen 333000,Chin)
出处
《中国医学创新》
CAS
2018年第10期120-123,共4页
Medical Innovation of China
基金
景德镇市科技计划项目(20171SFZC009)
