Chrisman H B, Omary R A, Nemcek A A, Ryu R K, Saker M B, Vogelzang R L
Division of Vascular and Interventional Radiology, Northwestern University Medical School, Chicago, Illinois, USA.
J Vasc Interv Radiol. 1999 Apr;10(4):473-5. doi: 10.1016/s1051-0443(99)70067-9.
To compare technical success and initial complication rates of peripherally inserted central catheters (PICCs) by interventional radiologists using ultrasound (US) or venographic guidance.
With use of a computer database, the authors retrospectively reviewed 2,650 procedures, 2,126 of which were performed with US and 524 with venography. Technical success was defined as placement of a PICC. Initial complications were defined as development of a hematoma, inadvertent arterial puncture, or neuropathy. Statistical significance was assessed using the chi2 test.
During 33 consecutive months, 2,650 procedures were performed with a complication rate of 1.0%. The technical success rate was 95.8% for venography and 99.6% for US. The initial complication rate was 0.75% for venography and 1.08% for US. There was no statistically significant difference in immediate complication rates (P = .50); however, there is statistical significance in regard to technical success (P < .001).
There is no difference in initial complication rates when comparing US and venographic guidance for PICC insertion. The decision to use either method can be based on clinical grounds and/or physician preference, although US has a higher initial success rate.
比较介入放射科医生在超声（US）引导或静脉造影引导下插入外周中心静脉导管（PICC）的技术成功率和初始并发症发生率。
作者利用计算机数据库回顾性分析了2650例操作，其中2126例在超声引导下进行，524例在静脉造影引导下进行。技术成功定义为PICC成功置入。初始并发症定义为血肿形成、意外动脉穿刺或神经病变。采用卡方检验评估统计学意义。
在连续33个月中，共进行了2650例操作，并发症发生率为1.0%。静脉造影的技术成功率为95.8%，超声引导的技术成功率为99.6%。静脉造影的初始并发症发生率为0.75%，超声引导的初始并发症发生率为1.08%。即时并发症发生率无统计学差异（P = 0.50）；然而，在技术成功率方面存在统计学意义（P < 0.001）。
比较超声引导和静脉造影引导下的PICC置入术，初始并发症发生率无差异。尽管超声引导的初始成功率较高，但选择使用哪种方法可基于临床情况和/或医生偏好。
