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电子胸片标尺测量技术在预测经外周静脉置入中心静脉导管置入长度的应用研究

Application of electronic chest radiograph scale measurement techniques in the prediction of placed length of peripherally inserted central venous catheters

摘要:

目的:采用电子胸片标尺测量技术预测经外周静脉置入中心静脉导管(PICC)置入长度,观察其临床效果。方法将2012年10月至2013年12月的185例乳腺癌患者作为对照组,将2014年1~11月的192例乳腺癌患者作为观察组。采用超声引导下结合改良塞丁格技术行PICC置管,对照组采用从穿刺点至右胸锁关节再向下反折至第3肋的PICC体外测量方法,观察组采用从穿刺点至右胸锁关节再加上右胸锁关节至隆突下1个椎体的长度,右胸锁关节至隆突下1个椎体的长度采用电子胸片标尺测量技术从电子胸片上直接测量。比较2种测量方法的准确率、并发症情况。结果观察组的准确率为97.92%(188/192),对照组为68.11%(126/185),观察组显著高于对照组,χ2=60.15,P<0.01,差异有统计学意义;观察组的并发症发生率为6.77%(13/192),对照组为20.54%(38/185),观察组显著低于对照组,χ2=9.58,P<0.01,差异有统计学意义。结论电子胸片标尺测量技术可有效提高PICC置入的准确率,有助于提高静脉穿刺质量,减少并发症的发生。

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Objective To predict the length of peripherally inserted central venous catheters(PICC) with electronic chest radiograph scale measurement techniques, and observe its clinical effect. Methods A total of 185 breast cancer patients from October 2012 to December 2013 who were treated by PICC combined with MST guided by ultrasonic technology were as control group. A total of 192 breast cancer patients from January to November 2014 were as observation group. Control group adopted from the puncture point to right sternoclavicular joints impreaaion nip down again to the third floor of PICC in vitro measurement method. Observation group used to right sternoclavicular joints from the puncture point plus right sternoclavicular joints to subcarinal 1 vertebral body length, right sternoclavicular joints to subcarinal 1 vertebral body length measurement by electronic chest radiograph scale technology directly measured from the electronic chest radiographs. The accuracy rates and complications between the two measurement methods were compared. Results The accuracy rate in observation group was 97.92%(188/192), which was higher than that in control group (68.11%,126/185 ),and there was significant differencek,χ2=60.15, P<0.01. The complication rate in observation group was 6.77%(13/192), which was lower than that in control group (20.54%, 38/185) ,and there was significant difference,χ2=9.58, P<0.01. Conclusions The electronic chest radiograph scale measurement techniques could effectively improve the accuracy of PICC catheter placed, improve the quality of venipuncture, decrease the complications .

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