摘要
目的探讨PICC正确置管长度的最佳体外测量方法。方法将62例行PICC置管患者随机分为A、B两组各31例,患者平卧位,外展手臂90°。A组采用从穿刺点至右胸锁关节再向下反折至第2肋的PICC体外测量法,B组采用从穿刺点至右胸锁关节再向下反折至第3肋间的PICC体外测量法,置管到达测量长度后,予胸部X线摄片定位。比较两组PICC管置入上腔静脉的成功率、置管长度。结果A组PICC管置入上腔静脉的成功率显著高于B组(P<0.05),A、B两组测得置管长度分别为(47.43±3.30)cm、(50.16±3.06)cm,与实际置管长度比较,差异无显著性意义(均P>0.05)。结论A组采用的体外测量法测量准确,可提高PICC管置入上腔静脉的成功率,且置管比较安全。
Objective To find the best way of external measurement for PICC. Methods Sixty-two patients who receiwed PICC were randomly divided into group A （n=31） and group B （n=31）. The patients were made to take a supine position, with the arm abducted to an angle of 90 degree. In the group A, the external measurement was made by measuring the distance from the puncture point, along the arm, to the right sternoclavieular joint, and then vertically back to the second rib. In group B, the external measurement was made by measuring the distance from the puncture point, along the arm. to the right sternoelavicular joint, and then vertically hack to the point between the third and the fourth rib. X-ray film was taken in the two groups after the catheter was introduced and the distance measured. Comparison in the rate of success （as indicated by the placement of the catheter tip into the superior vena eava） and the measured length was made between the two groups. Results The success rate of the first-time placement was higher in the group A than that in grouplB （P〈0. 05）. The measured lengths in the groups A and group Bwere （47. 43±3. 30） cmand （50. 16±3.06） cm. Therewerc no differences in the measured length and the length of catheter in the patients＇ body between the two groups （P〉0. 05. respectively）. Conclusion The external measurement methods used for the group A is better in terms of success rate and safety.
