Keywords:
Respiration; Catheterization; Central Venous; Malposition
呼吸;导管插入术;中心静脉;异位
Abstract:
Objective: To evaluate the effect of breathing coordination in reducing catheter tip malposition during PICC inserting. Methods: Totally 250 cancer patients receiving PICC were randomly assigned to two groups. The control group (n=123) received routine care during PICC inserting, while the experimental group (n=127) received breathing coordination guidance instead of turning head coordination. The incidence and sites of PICC malposition were compared between the two groups. Results: The total incidence of PICC malposition in the experimental group was significantly lower than that of the control group (1.57% vs 11.38%, x²=10.033, P=0.002). Significant differences were found in the incidences of malposition in internal jugular vein and axillary vein between the two groups (p<0.05), while no significant differences were found in the incidences of malposition in internal thoracic vein, azygos vein and folding back in subclavian vein between the two groups (p>0.05). Conclusion: Patients’ appropriate breathing coordination can reduce the incidence of catheter tip malposition during PICC inserting, especially in reducing the incidence of malposition in internal jugular vein and axillary vein.
目的:探讨恰当的呼吸配合对减少PICC置管术中导管异位的效果。方法:选择250例需行PICC置管治疗的肿瘤患者,随机分为观察组127例、对照组123例,对照组采用常规PICC置管操作,观察组将常规置管操作中的患者侧头配合改为呼吸配合,术后统计PICC异位部位及对应例数,对比组间异位发生率。结果:共发生16例导管异位,观察组2例,发生率1.57%;对照组14例,发 生率11.38%;两组异位发生率差异有统计学意义(x²=10.033,p<0.01),其中两组颈内静脉异位、腋静脉异位发生率差异有统计学意义(x²=4.850、4.197, p<0.05),两组胸廓内静脉异位、奇静脉异位、锁骨下静脉返折发生率差异无统计学意义(p>0.05)。结论:PICC置管操作中,患者恰当的呼吸配合可显著降低术中导管异位发生率,对降低颈内静脉异位、腋静脉异位的效果突出。