皮下隧道法减少赛丁格行PICC置管术中出血量研究.docVIP

皮下隧道法减少赛丁格行PICC置管术中出血量研究 　　摘 要 目的：探讨赛丁格（MST）技术经外周静脉穿刺置入中心静脉导管（PICC）的最佳进针方式。方法：收集2016年1月至6月在天平社区卫生服务中心住院部行PICC置管术患者50例，分为观察组和对照组各25例。观察组采用皮下隧道法穿刺，即在血管下方1～2 cm进针，不直接刺入血管，先皮下潜行1.0～1.5 cm，后刺入血管，再行PICC术。对照组采用常规静脉上方直接穿刺，再行PICC术，比较两组即刻出血量。结果：观察组出血量为（1.48±1.04）ml，对照组为（2.89±1.24）ml，组间差异有统计学意义（P0.05）。结论：采用皮下隧道法行PICC术的出血量比静脉上方穿刺直接刺入血管内行PICC术少。 　　关键词 出血；赛丁格；皮下隧道法；经外周静脉穿刺置入中心静脉导管 　　中图分类号：R472.9 文献标志码：A 文章编号：1006-1533（2017）20-0023-03 　　Study of the effect of the subcutaneous tunneling method in reducing the amount of hemorrhage during application of Saidingge in PICC catheter surgery 　　ZHU Heng 　　（Tianping Community Health Service Center of Xuhui District， Shanghai 200031， China） 　　ABSTRACT Objective： To investigate the optimal insertion method of Saidingge （MST） technique of peripheral venous puncture into the central venous catheter （PICC）. Methods： From January to June 2016， 50 patients underwent PICC catheterization in the Department of Tianping Community Health Service Center， and were divided into an observation group and a control group with 25 cases each. The observation group received subcutaneous tunnel puncture， that was， the needle was inserted 1～2cm below the blood vessel instead of inserting directly into the blood vessel， the needle sneaked subcutaneously for 1～1.5 cm first， entered the blood vessel secondary and last the PICC operation was performed. The control group was conventionally treated by directly puncture over the vein and then PICC was performed. The amounts of immediate hemorrhage of the two groups were compared. Results： The amount of hemorrhage of the observation group was （1.48±1.04） ml， and that of the control group was （2.89±1.24） ml， and the difference between the two groups was statistically significant （P0.05）. Conclusion： The amount of bleeding in PICC by subcutaneous tunnel method was less than that of direct puncture above vein into the blood vessels in PICC. 　　KEY WORDS hemorrhage； Saidingge； subcutaneous tunnel method； peripheral