血液病患儿透视导引锁骨下静脉置管方法学研究

发布时间：2018-06-18 18:04

本文选题：小儿 + 透视导引　；参考：《介入放射学杂志》2017年08期

【摘要】：目的探讨通过透视导引锁骨下静脉置管术(SVC)提高置管成功率,更好地确定导管头端位置,减少手术相关并发症发生。方法对183例1~16岁明确诊断为血液病患儿行透视下SVC术。观察置管成功率、穿刺针数、手术时间、透视时间和手术相关并发症发生情况。结果 183例患儿透视下SVC术均成功(100%)。穿刺3针成功151例(82.5%),4~6针成功25例,7~10针成功7例,全部导管头端均成功置于上腔静脉与右心房交界处。手术时间5~25 min,平均(10.38±4.04)min。透视时间16~607 s,平均(65.46±55.86)s。术中穿刺动脉2次(2例)。平均随访35 d,发生导管相关感染2例,未发生局部穿刺点血肿、血气胸、导管相关血栓形成等并发症。结论血液病患儿透视导引SVC术置管成功率高,穿刺针数较少,导管头端置放位满意率高,手术并发症少,是安全有效的方法之一。
[Abstract]:Objective to improve the success rate of catheterization by fluoroscopy guided subclavian vein catheterization (SVC), to determine the location of the catheter head and to reduce the complications associated with the operation. Methods SVC was performed in 183 children with hematologic disease at the age of 16 years. The success rate of catheterization, the number of puncture needles, the time of operation, the time of fluoroscopy and the occurrence of related complications were observed. Results all the 183 children underwent SVC under fluoroscopy successfully. 151 cases were successfully punctured with 3 needles in 151 cases, 25 cases were successful in 25 cases and 7 cases were successful in 7 cases. All the catheter heads were successfully placed at the junction of superior vena cava and right atrium. The operation time was 5 minutes and 25 minutes, with an average of 10.38 卤4.04 minutes. The fluoroscopy time was 16 ~ 607 s, with an average of 65.46 卤55.86 s. Two patients underwent arterial puncture during operation. The average follow-up time was 35 days, 2 cases of catheter-related infection occurred, no local hematoma, hemopneumothorax, catheter-related thrombosis and other complications occurred. Conclusion it is one of the safe and effective methods for children with hematologic diseases to have a high success rate of catheterization with SVC guided by fluoroscopy, fewer puncture needles, a high rate of satisfaction at the end of the catheter and fewer complications.
【作者单位】：南方医科大学南方医院介入诊疗科;
【分类号】：R473.72

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