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目的:探讨改良盲法穿刺技术在经外周静脉置入中心静脉导管(PICC)置管中的效果和可行性。方法:将我科需要PICC置管的70例病人随机分为经B超引导穿刺组和改良盲法穿刺组,每组各35例。记录两组病人一次穿刺成功率、一次置管成功率、穿刺点位置、上臂臂围、置管时间、静脉炎发生率、皮下淤血率等资料。结果:改良盲法穿刺组在一次穿刺成功率、一次置管成功率、穿刺点位置、静脉炎发生率、皮下淤血率与经B超引导穿刺组差异无统计学意义(P﹥0.05)。改良盲法穿刺组置管时间明显短于经B超引导穿刺组(P<0.001)。上臂臂围与改良盲法穿刺组一次成功率呈负相关(-0.475,P=0.004)。结论:改良盲法穿刺技术在PICC置管成功率较高,且不增加并发症和置管时间。
Objective: To explore the effect and feasibility of modified blind puncture technique in catheterization of central venous catheter (PICC) via peripheral vein. Methods: Seventy patients undergoing PICC catheterization in our department were randomly divided into B-guided ultrasonography group and modified blind puncture group, 35 cases in each group. The success rate of primary puncture, the success rate of primary catheterization, the position of puncture point, the arm circumference of upper arm, the time of catheterization, the incidence of phlebitis and the rate of subcutaneous congestion were recorded. Results: There was no significant difference in the success rate of primary puncture, the success rate of primary catheterization, the location of puncture point, incidence of phlebitis, subcutaneous congestion rate and B-guided ultrasonography in the modified blind puncture group (P> 0.05). The time of catheterization in the modified blind puncture group was significantly shorter than that in the B-guided puncture group (P <0.001). The arm success rate was negatively correlated with the first-time success rate (-0.475, P = 0.004). Conclusion: The improved blind puncture technique has a higher success rate of PICC catheter insertion and does not increase complications and catheterization time.