在全身麻醉期间由护士进行的超声导向外周插入中央导管 (PICC) 放置:一项回顾性队列研究
Ryo Koda1, Sayo Kondo2, Akihito Kakinuma3
1Nursing/Anesthesiology, Nagoya Tokushukai General Hospital, Tokushukai Medical Corporation, Aichi, JPN.
在重大腹部手术中,超声引导的外围插入中心导管 (PICC) 与中央静脉导管 (CVC) 相比,提供更快的放置时间和更长的停留时间. 这种技术表明,该技术可用于外科手术期间的中央静脉接入.
科学领域:
- 麻醉学和外科手术期间的医学.
- 血管接入 血管接入
- 手术护理 医疗护理
背景情况:
- 中心静脉通道对于主要的腹部手术至关重要.
- 中心插入的中央静脉导管 (CVC) 携带机械并发症的风险.
- 外围插入的中央导管 (PICC) 提供了一个替代方案,特别是在护士领导的工作流程中.
研究的目的:
- 评估超声波引导PICC安置的可行性和程序结果.
- 为了比较PICC安置与一般麻醉期间的传统CVC安置.
- 评估PICC在外科手术期间的安全性和效率.
主要方法:
- 在86名接受胃肠道手术的成年患者进行了回顾性观察性研究.
- 超声导向PICC组 (n=41) 和CVC组 (n=45) 的比较.
- 主要结局:导管放置时间;次要结局:停留时间,导管相关的血液感染 (CRBSI) 和闭塞.
主要成果:
- PICC安置时间显著缩短 (5.5分钟与7.0分钟相比,p=0.013).
- 在PICC组中,导管停留时间明显更长 (7.1 vs 3.3天,p<0.001).
- CRBSI发病率和闭塞率很低,在各组之间没有显著差异.
结论:
- 超声导向的PICC安置对于外科手术期间的中央静脉接入是可行的和高效的.
- 与CVC相比,PICC的放置时间较短,停留时间较长.
- 需要进一步的前性研究来确认安全性并探索工作流集成.
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