血管与导管选择对PICC置管引发并发症的影响

目的:通过比较PICC置管的血管与导管选择,探讨其对并发症发生率的影响。方法:2005年10月至2006年7月共336例恶性肿瘤病人应用B/BRAUN单腔导管,"可分裂"穿刺针355型173例,257型163例分别选择头静脉、贵要静脉、颈外静脉进行观察。结果:头静脉病人>50%出现并发症,其中30%出现中途拔管;贵要静脉<10%出现并发症,90%完成治疗计划;颈外静脉2例因固定不妥导致导管脱出。结论:在非高速度滴注的情况下,尽量选用小管径的导管;对血管的选择应当首选责要静脉,优选右侧,穿刺点最好过肘关节,其次选择颈外静脉优选右侧;选择PICC置管操作应慎重,操作之前做好详细的评估。

The Influence of Selecting Blood Vessel and Catheter on PICC Tube Causing Complications

Objective:To approach the influences on the incidence rate of complications by comparing different blood ves- sels and catheters of the PICC robe.Methods:From October 2005 to July 2006,there were totally 336 malignant tumors patients who used B/BRAUN single lumen catheter.Among the puncture needle applications,173 cases were received with the type 355, and 163 cases with the type 257.Then cephalic vein,basilic vein,and jugular external vein were respectively selected to observe. Results:Over 50% cephalic vein patients had complications,about 30% of whose tubes were pulled out in halfway.Less than 10% basilic vein patients had complications,and about 90% of them completed the treatment plan.Two jugular external vein cases had the catheters taken off because of the inappropriate fixing.Conclusion:It is better to choose small diameter catheter as far as possi- ble if it does not request super-speed drop.It's best to choose basilic vein at first,espedally the right side,with the puncture point going over the elbow joint;and the next best choice is the jugular external vein on the right side as well.Thereby,it is better to choose cautiously the PICC tube operation and make detailed valuation before operation.