【摘要】 目的探讨乳腺癌患者应用0.9%氯化钠注射液手工推注法与自然垂降生理盐水柱法经三向瓣膜式经外周静脉穿刺中心静脉置管(PICC)引导腔内心电图的效果比较。方法选取2017年1月至2018年10月我院收治的98例单侧乳腺癌患者作为研究对象,按随机数字表法分为观察组49例和对照组49例,对照组采用0.9%氯化钠注射液手工推注法打开三向瓣膜,观察组采用0.9%氯化钠注射液自然垂降法打开三向瓣膜,比较2种方法引导腔内心电图的导管尖端位置准确性、P波中断率、特征性P波出现率、0.9%氯化钠注射液用量及操作便捷性满意度。结果观察组导管尖端位置正常比例为94%,对照组导管尖端位置正常比例为80%,2组差异有统计学意义(P<0.05);观察组导管尖端位置最佳比例为90%,对照组导管尖端位置最佳的比例为73%,2组差异有统计学意义(P<0.05)。观察组P波中断比例为24%,对照组P波中断的比例为96%,2组差异有统计学意义(P<0.05);观察组出现特征性P波的比例为92%,对照组出现特征性P波的比例为71%,2组差异有统计学意义(P<0.05)。观察组的0.9%氯化钠注射液用量显著少于对照组,差异有统计学意义(P<0.05)。观察组的操作便捷性满意度评分明显高于对照组,差异有统计学意义(P<0.05)。结论静脉化疗的乳腺癌患者应用自然垂降0.9%氯化钠注射液柱法经三向瓣膜式PICC引导腔内心电图的效果理想,且操作更简便。更多还原

【Abstract】 Objective To investigate the efficacy of using manual saline bolus injection vs saline column drooping in intracavitary electrocardiogram(ECG) guidance of the three-way valved PICC among breast cancer patients. Methods Ninety-eight patients with unilateral breast cancer admitted to our hospital between January 2017 and October 2018 were randomly divided into study group(n=49) and control group(n=49). The three-way valve was opened by manual saline bolus injectionI in the control group, and by saline column drooping in the study group. The two methods were compared for the accuracy in intracavitary ECG guidance of the PICC tip, P wave interruption, oc-currence of characteristic P wave, use of normal saline, and satisfaction about convenience in manipulation. Results The rate of normal positioning of the catheter tip was 94% in the study group vs 80% in the control group, with statistically significant difference between the two groups(P<0.05). The rate of optimal positioning of the catheter tip was90% in the study group vs 73% in the control group, with statistically significant difference between the two groups(P<0.05). In the study group, P wave interruption occurred in 24% and characteristic P wave occurred in 92% of the times, compared with 96% and 71%, respectively, in the control group, with withstatistically significant differences(both P<0.05). The amount of saline use in the study group was significantly less than that in the control group( P<0.05). The satisfaction score for convenience in manipulation was significantly higher in the study group than that in the control group(P<0.05). Conclusion In breast cancer patients indicated for intravenous chemotherapy, saline column drooping can be an ideal method for intracavitary ECG guidance of PICC placement with more convenience in manipulation.更多还原