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目的 :总结疑难重症患者PICC成功置入经验,为临床提供置管技术指导。方法 :2015年1月至2016年6月为2580例疑难重症患者成功置入PICC,采用了建立血管分级标准、盲穿置管技术、超声引导下置管技术、超声初步判断导管位置方法以及设计心电图(EKG)定位专用转换夹等方面的综合改进措施。结果 :2580例患者中,血管重度损伤患者980例(38.0%)中,盲穿置管、超声引导下置管成功率分别为99.1%、99.9%;全身严重水肿患者851例(33.0%)中,盲穿置管、超声引导下置管成功率分别为99.0%、99.7%;皮肤极度松弛的患者439例(17.0%)中,超声引导下置管成功率为99.7%;肢体重度挛缩患者310例(12.0%)中,超声引导下置管成功率为99.7%。结论:通过对PICC置管技术改进使我院疑难患者置管成功率保持较高水平。
OBJECTIVE: To summarize the successful experience of PICC in patients with severe and severe diseases and provide guidance for catheterization in clinical practice. Methods: From January 2015 to June 2016, 2580 patients with severe and critical illness were successfully enrolled in PICC. The methods of establishing vascular grading standards, blind perforation technique, ultrasound-guided catheterization technique, ultrasonic catheterization method and design ECG (EKG) Positioning conversion folder and other special aspects of the comprehensive improvement measures. Results: Among 2580 patients, the success rates of cannulation and ultrasound guided cannulation were 99.1% and 99.9% respectively in 980 patients (38.0%) with severe vascular injury, and 851 (33.0%) patients with severe systemic edema , While the success rate of cannulated tube and ultrasound guided cannulation was 99.0% and 99.7% respectively. In 439 cases (17.0%) with extremely loose skin, the success rate of ultrasound guided cannulation was 99.7%. The patients with severe contracture of limbs 310 In the case (12.0%), the success rate of ultrasound guided catheterization was 99.7%. Conclusion: Through the improvement of PICC catheterization technique, the success rate of difficult catheterization in our hospital remains high.