摘要
目的测量和分析经外周置入中心静脉导管（PICC）术后胸片上中心静脉导管的实际置管长度,为体外测量＂横L法＂的改良提供参考。方法搜集行PICC的患者179例,术后常规摄胸部X线平片。在胸片上测量右侧（或左侧）肩胛盂至右侧胸锁关节的距离（AB）、中心静脉导管胸段的距离（AC）,计算二者的差值（AC-AB）即近似于＂横L法＂右胸锁关节向下反折至上腔静脉入口（CAJ）的反折段长度,采用统计学方法进行分析。结果右侧PICC置管119例,男31例,女88例,反折段长度男女对比差异有统计学意义（t=-3.386,P=0.002）;左侧PICC置管60例,男14例,女46例,反折段长度男女对比差异有统计学意义（t=-3.288,P=0.002）。男性、女性右侧置管与左侧对比反折段长度差异均无统计学意义（P〉0.05）。男性左右侧置管反折段长度55.99~140.53mm,平均（95.9493±20.60177）mm;女性左右侧置管反折段长度40.73~125.58 mm,平均（80.3437±16.34821）mm。结论 ＂横L法＂体外测量时,男性增加反折段长度7~9 cm,女性增加6~8 cm,可使导管头端位于上腔静脉下1/3至CAJ处,但置管后仍需摄胸部X线片监测导管头端位置以保证安全、有效。
Objective To measure and analyze the inserted length of a peripherally inserted central catheter in chest Radiography. Methods From October 2014 to August 2015,179 cases with chest X-ray examination after PICC replacement were collected to measure the length from the right（ or the left） glenoid to the right sternoclavicular joint（ AB）,and the length of PICC from the right（ or the left） glenoid to cavoatrial junction（ AC）. The difference between AB and AC（ AC-AB） were analyzed. Results In 119 cases with catheter on the right side,there was significant difference between 31 male cases and 88 female ones（ t =- 3. 386,P = 0. 002. In 60 cases with catheter on the left side,the difference between14 male cases and 46 female ones had statistical significance（ t =- 3. 288,P = 0. 002）. For male cases,no difference was found between the ones with catheter on right side and the ones with catheter on left side（ t = 0. 420,P = 0. 677）,and for female cases,no difference was found as well（ t = 1. 440,P = 0. 152）. The average difference between AB and AC of male cases was（ 95. 9493 ± 20. 60177） mm,and the one of female cases was（ 80. 3437 ± 16. 34821） mm. Conclusion Measuring the implanted length of PICC by using regular ＂ L＂ method,we should measure the length from the puncture point to the right sternoclavicular joint and then add 7- 9 cm（ male） or 6- 8 cm（ female）.
出处
《临床放射学杂志》
CSCD
北大核心
2016年第12期1890-1892,共3页
Journal of Clinical Radiology
关键词
经外周置入中心静脉导管
导管
胸片
测量
横L法
Peripherally inserted central catheter
Catheter
Chest photography
Measurement
Regular ＂L＂ method
