摘要
目的探讨生理盐水和导丝作为腔内心电图定位技术的导电介质,在乳腺癌患者上臂输液港植入术中的应用效果。方法于北京大学第一医院甲状腺乳腺外科选择植入上臂港行化疗的乳腺癌患者184例,随机分为生理盐水导电组91例和导丝导电组93例,比较两种腔内心电图定位方式的导管尖端位置准确率、特征性P波出现率、P波高度、QRS波高度、心电图稳定性评分、护士操作满意度评分以及置管时间。结果生理盐水组有87例(95.6%)导管尖端到达最佳位置,导丝组为92例(98.9%),差异没有统计学意义(χ^(2)=0.209,P=0.177)。2组患者在特征性P波出现率、P波高度、QRS波高度、心电图稳定性评分、护士操作满意度评分以及置管时间方面的比较,差异均无统计学意义(P>0.05)。结论在上臂港植入术中建议使用腔内心电图定位技术确保导管尖端位置正确性,导电介质选择生理盐水和导丝均可以达到满意效果,静疗专科护士可根据操作习惯及材料可及性选择任一种介质完成定位。
Objective To investigate the effect of using normal saline and guide wire as conductive media for intracavitary electrocardiogram-guided arm port implantation among breast cancer patients.Methods A total of 184 breast cancer patients who chose arm port as chemotherapy access were recruited at the Department of Thyroid Breast Surgery of Peking University First Hospital,and they were randomly divided into a guide wire electrode group and a liquid electrode group.The accuracy of catheter tip position,the occurrence rate of characteristic P wave,P wave height,QRS wave height,stability of electrocardiogram,nurse satisfaction,and length of operation were compared between two groups.Results The accuracy of catheter tip position was 95.6%in the liquid electrode group,while it was 98.9%in the guide wire electrode group,without significant difference between the two groups(χ^(2)=0.209,P=0.177).No significant difference was found in the occurrence rate of characteristic P wave,P wave height,QRS wave height,stability of electrocardiogram,nurse satisfaction,or length of operation between the two groups(P>0.05).Conclusion It is recommended to use intracavitary electrocardiogram to guide tip position in arm port implantation.Both guide wire electrode and liquid electrode can lead to a success of the surgery.The intravenous specialist nurses can choose either of them according to their own habit and medium availability.
作者
刘飞
王影新
马骍
辛灵
程元甲
刘倩
王悦
张军军
Liu Fei;Wang Yingxin;Ma Xing;Xin Ling;Cheng Yuanjia;Liu Qian;Wang Yue;Zhang Junjun(Department of Thyroid Breast Surgery,Peking University First Hospital,Beijing 100034,China;Nursing Department,Peking University First Hospital,Beijing 100034,China)
出处
《中华临床医师杂志（电子版）》
CAS
北大核心
2023年第7期760-764,共5页
Chinese Journal of Clinicians(Electronic Edition)
基金
北京大学第一医院科研种子基金(2021SF46)
