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浅析呼吸配合在减少PICC置管异位中的应用

Analysis of the Application of Respiratory Coordination in Reducing PICC Catheter Ectopic

Frontiers of Clinical Medicine / 2022,4(2)：63-72 / 2022-06-01 562 622

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• Authors: 胡勤容      姚曼     
• Information:

  南通市肿瘤医院，南通
  

• Keywords: 呼吸；导管插入术；中心静脉；异位
• Respiration; Catheterization; Central Venous; Malposition
• Abstract: 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。
• 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.
• DOI: https://doi.org/10.35534/fcm.0402007c
• Cite: 胡勤容，姚曼．浅析呼吸配合在减少 PICC 置管异位中的应用［J］．临床医学前沿，2022，4（2）：63-72