B超引导联合改良赛丁格技术运用与肿瘤患者PICC致血栓形成相关性研究.docVIP

B超引导联合改良赛丁格技术运用与肿瘤患者PICC致血栓形成相关性研究 　　【关键词】 置管方式;肿瘤患者;PICC;上肢静脉血栓 　　中图分类号：R472 文献标识码：A DOI：10.3969/j.issn.1003-1383.2018.01.010 　　Study on the correlation between B-ultrasound guidance combined with modified Seldinger’s technique in thrombosis induced by PICC in tumor patients 　　LI Junli，HUANG Fangyan，WEI Guiyuan，YANG Mei，LIU Jia 　　【Abstract】 Objective To investigate the effect of B-ultrasound guidance combined with modified Seldinger’s technique （MST） on upper extremity vein thrombosis induced by peripherally inserted central venous catheters （PICC），so as to provide evidence for the prevention of thrombosis in clinical practice. 　　Methods 216 patients who needed PICC catheterization from June，2015 to January，2017 were selected as research subjects.Grouping was performed according to the way and location of the puncture.Patients who were given puncture catheterization by B-ultrasound guidance combined with MST at 3～10 cm above elbow joint were selected as observation group（119 cases），and patients who were given catheterization by blind puncture at 2～3 cm below elbow joint were selected as control group（97 cases）.Both groups were given routine nursing care after catheterization，and the incidence of venous thrombosis was observed. 　　Results There were 3 cases of venous thrombosis （2.52%） in the observation group and 9 cases （9.28%） of venous thrombosis in the control group，difference was statistically significant（Plt;0.05）. 　　Conclusion B-ultrasound guidance combined with MST for catheterization in elbow can reduce the incidence of PICC of tumor patients，prolong the use time of catheterization，reduce unplanned extubation rate，and improve the safety of patients with catheter. 　　【Key words】 catheterization method;tumor patients;PICC;upper limb vein thrombosis 　　PICC是中?L期静脉输液患者首选的静脉输液通道，特别是肿瘤治疗领域，可为患者提供一条方便安全的静脉通道。但PICC留置期间会因为各种原因导致导管相关性感染、机械性静脉炎和血栓等并发症，其中静脉血栓是最严重的并发症之一，可导致肺栓塞等血栓后综合征，危及患者生命。国外多项研究显示，PICC所导致的导管相关性静脉血栓发生率为2%～38.5%[1～2]。赵菁等人[3]的研究结果提示，肿瘤患者PIC