本文關(guān)鍵詞：心電監(jiān)護在輔助超聲引導(dǎo)下改良塞丁格技術(shù)經(jīng)外周中心靜脈置管的臨床研究　出處：《中國循環(huán)雜志》2016年10期 　論文類型：期刊論文

  更多相關(guān)文章： 心電描記術(shù) 導(dǎo)管插入術(shù) 中心靜脈 P波

【摘要】：目的:研究心電監(jiān)護在輔助超聲引導(dǎo)下改良塞丁格技術(shù)(MST)經(jīng)外周中心靜脈置管(PICC)并根據(jù)心電圖變化判斷導(dǎo)管末端位置的準確率。方法:104例患者連接心電監(jiān)護儀,置管時利用導(dǎo)絲與心電監(jiān)護儀RA導(dǎo)聯(lián)相連引出腔內(nèi)心電圖,根據(jù)P波特征性變化對PICC導(dǎo)管末端位置進行判斷,判斷結(jié)果再與置管后根據(jù)X線胸片判斷的導(dǎo)管末端位置結(jié)果進行比較,比較兩種方法判斷結(jié)果的一致性,計算心電判斷法的靈敏度和特異度。結(jié)果:104例患者中有100例患者出現(xiàn)特征性P波,心電判斷結(jié)果與X線胸片判斷結(jié)果一致率為96.2%。4例未出現(xiàn)特征性P波的患者X線胸片顯示,有2例導(dǎo)管末端位于上腔靜脈上段、1例位于上腔靜脈下端、1例位于對側(cè)頭臂靜脈。兩種方法的判斷結(jié)果無統(tǒng)計學(xué)差異。靈敏度為99%,特異度為100%。結(jié)論:心電監(jiān)護輔助超聲引導(dǎo)下改良塞丁格技術(shù)PICC時可以根據(jù)心電圖特征性P波對導(dǎo)管末端位置進行判斷,而無需拍攝X線胸片,且此方法不會對患者帶來額外的創(chuàng)傷,也無放射性污染。心電監(jiān)護與臨床超聲引導(dǎo)下改良塞丁格技術(shù)PICC相結(jié)合可以使PICC得到更廣泛的應(yīng)用。
[Abstract]:Objective: To study the ECG monitoring under the guidance of modified Seldinger technique in ultrasonic assisted (MST) peripherally inserted central venous catheter (PICC) and to determine the accuracy rate of the catheter tip position according to the ECG changes. Methods: 104 cases of patients with connected ECG monitor, when the catheter guide wire is connected with the use of RA lead ECG leads to endocardial mapping according to the characteristic changes of P wave, to judge PICC catheter tip position, compare the catheter tip location of the results and the judgment result after catheter based on chest X-ray to judge the consistency between the two methods to judge the results of the calculation of sensitivity and specificity of ECG judgment method. Results: 104 cases of 100 patients there is the characteristic of P wave, ECG results and chest X-ray results determine the consistent rate of 96.2%.4 cases without X-ray characteristics showed that patients with P wave judgment, 2 cases of distal end of the catheter in the superior vena cava segment, 1 cases In the superior vena cava is 1 cases in the contralateral brachiocephalic vein. There was no difference between the two methods of judgment. The sensitivity was 99%, specificity was 100%. conclusion: ECG assisted ultrasound-guided modified Seldinger technique PICC according to the ECG characteristics of P wave to judge the position of the catheter tip, without the chest X-ray was taken, and this method does not bring additional trauma to the patient, no radioactive pollution. ECG monitoring and clinical ultrasound-guided modified Seldinger technique combined with PICC can make PICC more widely used.

【作者單位】： 錦州醫(yī)科大學(xué);錦州醫(yī)科大學(xué)附屬第一醫(yī)院腫瘤科;
【分類號】：R472
【正文快照】： 方法:104例患者連接心電監(jiān)護儀,置管時利用導(dǎo)絲與心電監(jiān)護儀RA導(dǎo)聯(lián)相連引出腔內(nèi)心電圖,根據(jù)P波特征性變化對PICC導(dǎo)管末端位置進行判斷,判斷結(jié)果再與置管后根據(jù)X線胸片判斷的導(dǎo)管末端位置結(jié)果進行比較,比較兩種方法判斷結(jié)果的一致性,計算心電判斷法的靈敏度和特異度。結(jié)果:104

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