在ICU患者的外围插入中央导管放置的修改的两阶段外套扩张器技术的出血结果:一项回顾性队列研究
Ting-Chia Young1,2, Kuang-Hua Cheng2,3,4, Ying-Hung Tang5,6
1Department of Medical Education, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
The journal of vascular access
|October 3, 2025
概括
一种新的两阶段技术在ICU患者的外围插入中心导管 (PICC) 放置期间显著减少出血. 这种方法为传统的塞尔丁格技术提供了更安全的替代方案,改善了血液静止和潜在的ICU护理.
科学领域:
- 血管接入程序 血管接入程序
- 临界护理医学 临界护理医学
- 干预心脏病学 干预心脏病学
背景情况:
- 机械并发症,包括出血,在周围插入的中央导管 (PICC) 放置在重症监护室 (ICU) 患者时很常见.
- 尽量减少手术出血对于患者的安全和减少重症患者的并发症至关重要.
- 这项研究研究了一种修改后的PICC插入的两阶段技术,以减轻与传统的塞尔丁格技术相比的出血风险.
研究的目的:
- 评估修改后的两阶段技术在PICC安置期间减少插入相关出血的有效性.
- 为了在ICU患者中比较两阶段技术和传统修改的Seldinger技术之间的出血结果.
主要方法:
- 一项比较研究涉及86名患者和92名ICU环境中的PICC安置.
- 使用修改的两阶段技术 (56个放置) 或传统的修改的塞尔丁格技术 (36个放置) 进行PICC插入.
- 输入后5分钟,30分钟和24小时半定量评估出血情况.
主要成果:
- 与传统方法相比,两阶段技术在所有评估时间点上显示出明显较低的出血发生率.
- 在插入5分钟后,93%的两阶段组患者经历了最小的或没有出血,而传统组的28%.
- 多变量分析证实了两阶段技术与降低出血风险的独立关联 (OR,0.019;p < 0.001).
结论:
- 修改后的两阶段技术是ICU患者PICC安置的可行且有效的替代方案,显著减少了与插入相关的出血.
- 这种技术促进了更稳定的血静,在24小时内更少的连衣更换.
- 这些发现表明,通过更安全的PICC插入方法,可以提高ICU护理质量.
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