心电图引导PICC尖端定位的多中心研究

发布时间：2018-01-07 11:34

本文关键词：心电图引导PICC尖端定位的多中心研究　出处：《中华护理杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的探讨心电图引导PICC尖端定位的准确性及体外测量长度对最佳置入长度的预测价值。方法便利抽取了全国11个省、市、自治区的18所三级甲等医院的743例置管患者进行心电图引导PICC尖端定位。置管到达最佳位置后,进行胸部X线定位,观察心电图引导PICC尖端定位的准确性。结果 624例患者经心电图引导PICC尖端定位后,X线胸片显示导管尖端均在最佳位置。PICC尖端最佳置入长度与体外测量长度呈正相关(r=0.920,P0.01)。以PICC最佳置入长度(Y)为因变量,以体外测量长度(X)为自变量,采用逐步线性回归,得出回归方程为:左侧贵要静脉Y=4.290+0.897X(R~2=0.834,F=942.459,P0.001),右侧贵要静脉Y=3.097+0.922X(R~2=0.855,F=2055,P0.001)。结论对于心电图有P波的患者,P波变化可用来指导置管操作和预测导管尖端位置,心电图定位可作为一种替代性方法。经贵要静脉置入PICC时,可借助线性回归方程,预测导管置入长度。
[Abstract]:Objective to explore the value of prediction accuracy and measuring the length of in vitro ECG guided PICC tip positioning on the optimum insertion length. A convenience sample of the country's 11 provinces, city, autonomous region 18 three hospitals and 743 cases of catheter patients ECG guided PICC catheter tip location. To reach the best position, chest X-ray the positioning accuracy, observe the ECG guided PICC tip positioning. Results 624 cases of patients with ECG guided PICC tip position, chest X-ray showed the catheter tip are in the best position of the tip of.PICC optimal insertion length and length measurement in vitro was positively correlated (r=0.920, P0.01). The PICC optimal placement length (Y) as the dependent variable, in vitro measure the length (X) as the independent variable, stepwise linear regression, the regression equation was: on the left side of the basilic vein Y=4.290+0.897X (R~2=0.834, F=942.459, P0.001), Y=3.097+0.922X R (on the right side of the basilic vein ~2=0.855, F=2055, P0.001). Conclusion for patients with P wave ECG, P wave changes can be used to guide the catheter operation and prediction of catheter tip position, ECG can be used as an alternative method. The basilic vein in PICC, with the linear regression equation, prediction of catheter insertion length.

【作者单位】：北京医院护理部/国家老年医学中心;
【分类号】：R472
【正文快照】： 目前,PICC在临床得到了广泛的应用。一般PICC尖端应置于上腔静脉末端,靠近上腔静脉与右心房入口交界处为最佳位置[1]。一直以来,X线定位法被视为PICC尖端定位的“金标准”,但一旦发现定位错误需要重新置管,不仅耗费时间,同时增加了辐射暴露的机会,并且禁用于孕妇。心电图引导P

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