PICC和锁骨下静脉置管在颅脑危重症患者中应用效果观察.docVIP

PICC和锁骨下静脉置管在颅脑危重症患者中应用效果观察 　　[摘要] 目的：观察外周静脉穿刺导入中心静脉置管（PICC）与锁骨下静脉置管两种方法在颅脑危重患者中的应用效果。方法：72例置管患者随机分为PICC组36例和锁骨下静脉组36例，分别观察两种方法置管的1次置管成功率、并发症及置管时间的长短。结果：PICC组一次置管成功率为100%，而锁骨下静脉置管组的一次置管成功率为63.8%，具有显著性差异（P0.05）；PICC组导管留置时间长于锁骨下静脉组，具有显著性差异（P0.01）；锁骨下静脉组发生导管相关性感染、邻近动脉损伤、导管脱落的例数较多，而PICC组发生静脉炎的例数则高于锁骨下静脉置管组。结论：PICC导管的穿刺简便易行，并发症少，可长期留置。 　　[关键词] PICC；锁骨下静脉置管；颅脑危重症 　　[中图分类号]R651[文献标识码]A [文章编号]1673-7210（2007）07（c）-011-02 　　 　　Observation of applications of PICC and subclavian vein puncture in cerebral critical patients 　　YOU xiao mei ,ZENG Li-mei 　　(The Peoples Hospital of ping shan, ping shan518118,China) 　　[Abstract] Objective:To compare the effect of applications of PICC and subclavian vein puncture in cerevreal critical patients. Methods: 72 patients were divided into two groups randomly, group of peripherally inserted central catheter (PICC, n=36) and group of subclavian vein puncture (n=36). The successful rate of the initial puncture, indwelling time and complications were observed respectively. Results:The successful rate of the initial puncture was 100% in PICC group and 63.8% in another group, which showed significant difference statistically (P0.05). Indwelling time was significantly longer in PICC group than that of subclavian vein puncture group (P0.01). And there were more correlative infection of catheter, adjacent artery damages and dislocation of catheter in subclavian vein puncture group. While more phlebitis in PICC group, Conclusion:The method of PICC is convenient to handle and less dangerous, produces fewer pain for patients, has few complications, and can be remained for long time. 　　[Key Words] PICC; Subclavian vein punctare; Cerebral 　　 　　颅脑外伤危重患者具有病情重、变化快、并发症多的临床特点，常常需要长期静脉输液。反复周围静脉穿刺无疑增加了患者的痛苦，同时也增加了液体外渗所造成的局部组织坏死的危险。而经外周静脉穿刺的中心静脉置管（PICC）和锁骨下静脉置管对于颅脑危重患者均是较好的选择。我科就两种方法的应用效果进行对比。对两种插管方式进行了临床观察比较，分析如下。 　　 　　1 对象与方法 　　 　　1.1 对象 　　选自2004年1月～2006年12月在我科住院的颅脑危重患者72例，随机分为两组，经肘正中静脉穿刺的中心静脉置管36例患者为PICC组，男20例，女16例，年龄40～73岁，脑挫裂伤7例，重型颅脑损伤15例，高血