CT定位上腔静脉在评价PICC置管中的应用价值

发布时间：2018-02-12 23:02

本文关键词： 体层摄影术 X线计算机外周静脉置入中心静脉导管上腔静脉　出处：《临床放射学杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的观察上腔静脉与气管隆突的影像关系并评价其在外周静脉置入中心静脉导管(PICC)中的应用价值。方法测量100例胸部CT增强患者(增强观察组)气管隆突至上腔静脉下端的距离及其对应的胸椎单元数目,并计算上腔静脉下1/3段的上端在气管隆突下所处的位置。以上腔静脉下1/3段作为PICC尖端的理想位置,在CT定位扫描图判断100例PICC患者(导管组)是否置管成功。结果增强观察组上腔静脉下端(即下上腔静脉1/3段的下端)位于气管隆突下(48.5±6.7)mm,对应2.1±0.3个胸椎单元,而上腔静脉下1/3段的上端位于气管隆突下(21.5±5.9)mm,对应0.9±0.3个胸椎单元。以气管隆突下0.9~2.1个胸椎单元作为上腔静脉下1/3段的参考标准,在导管组CT定位图上判断PICC尖端是否位于理想位置的准确性高于以气管隆突下21.5~48.5mm作为参考标准(92%vs 71%,P0.05)。结论气管隆突下0.9~2.1个胸椎单元可以作为判断PICC尖端是否位于上腔静脉下1/3段的参考。
[Abstract]:Objective to observe the imaging relationship between superior vena cava and tracheal protuberance and to evaluate its application in central venous catheter PICC.Methods 100 cases of chest CT enhancement were measured in the superior lumen of trachea Carina in contrast group. The distance at the lower end of the vein and the corresponding number of thoracic vertebrae units, The location of the upper end of the 1/3 segment of inferior inferior vena cava in the subtracheal protuberance was calculated. 1/3 segments of the superior inferior vena cava were regarded as the ideal position at the tip of PICC. Results the inferior end of superior vena cava (the lower end of inferior superior vena cava) in the contrast group was 48.5 卤6.7 mm below the protuberance of trachea, corresponding to 2.1 卤0.3 thoracic vertebrae unit. The upper end of the inferior 1/3 segment of inferior vena cava was 21.5 卤5.9 mm in the subtracheal protuberance, corresponding to 0.9 卤0.3 thoracic vertebrae units. The thoracic vertebrae unit of 0.9 ~ 2.1 subtracheal protuberance was used as the reference standard for the 1/3 segment of the inferior vena cava. The accuracy of judging whether the tip of PICC is in the ideal position on CT localization map of catheter group is higher than that of using 21.5 mm of subtracheal protuberance as the reference standard. Conclusion\\\. Reference to subvena cava 1/3 segment.
【作者单位】：中山大学附属第五医院放射科;
【分类号】：R446.8;R816.2

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