摘要
目的:分析腔内心电图技术在胃癌化疗患者经外周静脉穿刺中心静脉置管(PICC)尖端定位中的应用及对置管并发症的影响。方法:本研究选取2018年3月—2020年1月入住解放军总医院海南医院的胃癌化疗患者300例作为研究对象,按照随机数字表法分为研究组和对照组,对照组采用X线胸片检查定位穿刺,研究组采用腔内心电图技术引导的PICC置管尖端定位。比较两组患者在穿刺点出血量、PICC置管并发症、一次尖端到位率和异位率、导管尖端具体位置、PICC置管定位所需时间和费用。结果:研究组胃癌化疗患者穿刺点出血量显著低于对照组(P<0.05)。研究组胃癌化疗患者置管并发症总发生率(2.67%,4/150)显著低于对照组(16.67%,25/150)(P<0.05)。研究组一次尖端到位率显著高于对照组(P<0.05),一次尖端异位率显著低于对照组(P<0.05)。研究组导管尖端位置最佳占比显著高于对照组(P<0.05),位置过浅和过深占比显著低于对照组(P<0.05)。研究组PICC置管定位所需时间以及费用显著低于对照组(P<0.05)。结论:腔内心电图技术应用于胃癌化疗患者PICC置管尖端定位时可以提高一次到位率,降低PICC置管并发症的发生率以及PICC置管定位所需时间和费用。
Objective:To analyze the application of intracavitary electrocardiogram(ECG)in the tip positioning of the peripherally inserted central catheter(PICC)and its influence on the complications of PICC in gastric cancer patients undergoing chemotherapy.Methods:In this study,300 patients with gastric cancer undergoing chemotherapy admitted to Hainan Hospital of Chinese PLA General Hospital from March 2018 to January 2020 were included and divided into the study and the control group by random number table method.The puncture points of the PICC catheter in the control group were located by X-ray,and those in the study group were located under the guidance of intracavitary ECG.The bleeding volume during puncturing,the complications of PICC catheterization,the one-time successful and failure rates of puncturing,the specific location of the catheter tip,and the time and cost of PICC positioning were compared between the two groups.Results:The bleeding volume during puncturing in the study group was lower than that in the control group(P<0.05).The total incidence of catheterization complications in the study group(2.67%,4/150)was lower than that in the control group(16.67%,25/150)(P<0.05).The successful rate of puncturing under the guidance of intracavitary electrocardiogram was higher than that of the control group(P<0.05),while the failure rate of puncturing was lower(P<0.05).The proportion of the best tip position in the study group was higher than that in the control group(P<0.05).The time and cost of PICC placement in the study group were obviously lower than those in the control group(P<0.05).Conclusion:Applying intracavity ECG in PICC catheterization can increase the successful puncture rate,reduce the incidence of PICC complications,and reduce the time and cost for patients with gastric cancer undergoing chemotherapy.
作者
刘咏梅
刘辉
孙婷婷
于庭
程志芳
邓甜甜
LIU Yongmei;LIU Hui;SUN Tingting;YU Ting;CHENG Zhifang;DENG Tiantian(Ambulatory Clinic,Hannan Hospital of Chinese PLA General Hospital,Sanya 572000,Hainan,China;Orthopedics,Hannan Hospital of Chinese PLA General Hospital,Sanya 572000,Hainan,China;Comprehensive Treatment Room,Hannan Hospital of Chinese PLA General Hospital,Sanya 572000,Hainan,China)
出处
《武汉大学学报（医学版）》
CAS
2024年第7期831-835,共5页
Medical Journal of Wuhan University
基金
海南省自然科学基金青年基金项目(编号:818QN322)。
关键词
腔内心电图
经外周静脉穿刺中心静脉置管
导管定位
胃癌
并发症
Intracavitary Electrocardiogram
Central Venous Catheterization via Peripheral Venous Puncture
Catheter Localization
Gastric Cancer
Complications
