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目的探讨B超不同角度引导下配合两种穿刺技术对经外周静脉置入中心静脉导管(PICC)的临床研究。方法 135例穿刺置管患者作为研究对象,将患者随机分为观察组(78例)和对照组(57例)。观察组采用B超引导下改良的Seldinger技术进行PICC穿刺置管,对照组在普通彩超引导下采用常规穿刺法进行PICC穿刺置管。对比两组穿刺效果。结果对照组患者皮下厚度>3 cm的患者PICC置管成功率为86.0%,观察组患者皮下厚度>3 cm的患者PICC置管成功率为96.2%,两组皮下厚度>3 cm的患者PICC置管成功率比较差异有统计学意义(P<0.05)。对照组患者皮下厚度<0.5 cm的患者PICC置管成功率为96.5%,高于观察组的82.1%,差异具有统计学意义(P<0.05)。两组患者穿刺处渗血、穿刺处渗液情况比较差异有统计学意义(P<0.05)。两组出现导管堵塞、静脉炎、感染情况比较差异无统计学意义(P>0.05)。结论对于皮下厚度<0.5 cm的患者选用普通彩超下PICC置管;皮下厚度>3 cm尽量选择改良的Seldinger技术进行置管;普通彩超穿刺处渗血和渗液少,患者耐受性好,操作简单。
Objective To investigate the clinical study of transcatheter arterial catheterization (PICC) guided by different degrees of B-ultrasound guided by two punctures. Methods A total of 135 patients undergoing catheterization and catheterization were randomly divided into observation group (78 cases) and control group (57 cases). The observation group received PICC puncture and catheterization with modified Seldinger technique guided by B-ultrasound, and the control group received PICC puncture and catheterization by conventional puncture under the guidance of ordinary color Doppler ultrasound. Compare the two groups of puncture effect. Results The success rate of PICC catheterization was 86.0% in patients with subcutaneous thickness> 3 cm in control group and 96.2% in patients with subcutaneous thickness> 3 cm in observation group, and PICC in patients in subcutaneous thickness> 3 cm The success rate of tube was significantly different (P <0.05). PICC catheterization success rate was 96.5% in patients with subcutaneous thickness <0.5 cm in control group, which was significantly higher than that in observation group (82.1%, P <0.05). There were significant differences between the two groups in the bleeding of the puncture site and in the puncture site (P <0.05). Two groups of catheter blockage, phlebitis, infection was no significant difference (P> 0.05). Conclusion For subcutaneous thickness less than 0.5 cm, patients underwent general color Doppler ultrasonography (PICC) catheterization; subcutaneous thickness> 3 cm as much as possible to choose the modified Seldinger technique for catheterization; ordinary color ultrasonography puncture less bleeding and exudation, patient tolerance, operation simple.