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目的 探讨PICC最佳预测长度与身高、体质量指数之间的相关性,为PICC置管理想深度提供一种较为准确的预测方法.方法 选取2018年1月PICC置管的100例患者,采用自身对照研究的方法,同一患者同时采用2种不同的体外测量方法.传统测量法采用Rountree法即从穿刺点至右胸锁关节再向下返折至第三肋间获得预测长度,这组方法仅用于测量并进行数据记录作为对照.实验测量法采用改良法即从穿刺点至右胸锁关节的长度再加上根据身高及体质量指数预加6～10 cm为预测长度,这组方法应用于实际置管.置管后的X线胸片确定导管理想长度.传统Rountree法预测导管的长度为A:42(40,44)cm,实验法测得的长度为B:40(39,42)cm,理想测量长度为C:40(38,41)cm.对其3组长度数据进行Kruskal_Wallis H检验分析,通过多重线性回归分析比较身高、体质量指数与PICC置管长度的相关性.结果 实验法预测的长度更接近理想长度(P=0.657),回归模型具有统计学意义[F(2,97)=36.931,P﹤0.01,调整R2=0.421].纳入的身高、体质量指数对预测理想导管长度均有统计学意义(P﹤0.05).结论 采用从穿刺点至右胸锁关节再加上根据身高、体质量指数预加6～10 cm为导管预测长度,更接近理想长度.

Objective To explore the correlation between PICC optimal prediction length and height, body mass index, and provide a more accurate prediction method for PICC depth management. Methods A total of 100 patients with PICC catheterization in January 2018 were selected for self_controlled study, and two different in vitro measurement methods were used for the same patient at the same time.Traditionally, the Rountree method is used to obtain the predicted length from the puncture point to the right sternoclavicular joint and back down to the third intercostal space (A). This group of methods is used only for measurement and data recording as A control.The experimental measurement method adopted the modified method, that is, the length from the puncture point to the right sternoclavicular joint, plus the predicted length based on the pre_addition of 6-10cm according to the height and body mass index (B). This group of methods was applied to the actual catheterization.The ideal length of the catheter was determined by chest radiograph after catheterization (C).The length of the catheter is predicted by traditional Rountree methods (A) 42.0 ± 2.867cm, experimentally measured (B) 40.30± 2.435cm, and idealized (C)39.81± 2.411cm.Kruskal_wallis H test and analysis of three lengths of data A, B and C were performed, and the correlation between height, body mass index and PICC catheter length was compared through multiple linear regression analysis. Results the length predicted by the experimental method was closer to the ideal length (P=0.657), and the regression model had statistical significance, F(2,97)=36.931, P<0.01, and adjusted, R2=0.421. The included height and body mass index (BMI) were statistically significant in predicting ideal catheter length (P<0.05). Conclusions The length of the catheter was predicted from the puncture point to the right sternoclavicular joint plus 6-10cm according to the height and body mass index, which was closer to the ideal length.