经外周至中心静脉插管与股静脉插管在呼吸科患者中的应用比较

目的比较经外周至中心静脉插管(PICC)与股静脉穿刺插管(简称股穿)的优缺点。方法比较两组的穿刺插管成功率、操作时间、留置时间及并发症发生率。结果PICC组一次成功率高于股穿组(P<0.05),穿刺成功率、插管成功率及总成功率无显著差异(P>0.05)。平均操作时间PICC组(12.5min)少于股穿组(23.5min)(P<0.05)。导管留置时间及各种原因拔管情况比较无显著差异(P>0.05)。两组并发症总发生率比较无显著差异(P>0.05),但股穿组导管细菌培养阳性率高于PICC组(P<0.05)。结论PICC插管操作简捷、安全,但导管的应用受到肘部血管条件的限制。股静脉穿刺插管的应用范围广泛,尤其在呼吸病患者的应用方面有独到之处,缺点是容易导致感染。因此,PICC和股静脉穿刺插管在呼吸病患者的治疗中可以互补。

Comparison between Peripherally Inserted Central Catheters and Femoral Venous Catheters in Treatment of Respiratory Diseases

Objective To determine the advantages and disadvantages of peripherally inserted central catheters (PICC) and femoral venous catheters (FVC) in the treatment of respiratory diseases. Methods Patients with a variety of respiratory diseases received PICG ( n = 27) and FVC ( n =29). Successful rates of puncturing, operational time, retained time and incidence of complications were compared between the two groups. Results The rate of successful puncturing was higher in PICC group than that in FVC group ( P <0. 05) ,but the difference was not significant in the overall successful rate of catheterization between the two groups. Mean time needed in PICC was less than that in FVC (12. 5 min versus 23.5 min). There was no significant difference in the median placement time of the two groups. The difference was not significant in the incidence of complications between the two groups ( P >0. 05) , but the positive rate of bacteria culture in FVC was higher than that in PICC ( P <0. 05). Conclusion The benefits of PICC include rapidness and safety, but the application of PICC is limited by the elbow venous condition of patients. FVC has wider application and a unique function in the treatment of respiratory diseases. Infection is more likely for FVC. We suggest that selection of the catheters should be based on the condition of patients.