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动力注射式外周静脉穿刺中心静脉导管在注射造影剂后经常出现导管移位。

Power injectable peripherally inserted central venous catheter lines frequently flip after power injection of contrast.

作者信息

Lozano Luis Antonio Sosa, Marn Charles, Goodman Lawrence R

机构信息

Department of Radiology, Froedtert Memorial Lutheran Hospital, Medical College of Wisconsin, Milwaukee, WI 53226, USA.

出版信息

J Comput Assist Tomogr. 2012 Jul-Aug;36(4):427-30. doi: 10.1097/RCT.0b013e3182575b88.

Abstract

OBJECTIVE

To determine the frequency of power injectable peripherally inserted central venous catheter (PIPICC) displacement after contrast injection for computed tomography.

MATERIALS AND METHODS

We included all patients who had a computed tomographic examination with contrast administration via PIPICC over a 4-month period. Several variables including catheter location before and after the injection were documented. Descriptive statistics were used for continuous variables. The χ² test was used to compare groups. Continuous variables were analyzed using the Student t test.

RESULTS

Among 78 injections in 67 patients (34 men and 33 women; median age, 49 years), there were 12 catheter displacements (15.4%): 5 (62.5%) of 8 catheters initially located proximal to the tracheobronquial angle (TBA) and 7 (10.14%) of 69 catheters initially located distal to the TBA. The initial catheter position before the injection correlated with the frequency of displacement significantly (P < 0.006). Contrast injection rate and amount of contrast were no risk factors for position change. There were no complications.

CONCLUSION

Catheter displacement occurred in 62.5%, with PIPICCS cephalad to the TBA. A preliminary scout view should be checked before the contrast injection. In addition, a postinjection scan scout view is recommended to verify catheter position.

摘要

目的

确定在计算机断层扫描造影剂注射后,可动力注射的外周置入中心静脉导管(PIPICC)移位的发生率。

材料与方法

我们纳入了在4个月期间通过PIPICC进行计算机断层扫描检查并注射造影剂的所有患者。记录了包括注射前后导管位置在内的几个变量。连续变量采用描述性统计。采用χ²检验比较组间差异。连续变量采用Student t检验进行分析。

结果

在67例患者(34例男性和33例女性;中位年龄49岁)的78次注射中,有12次导管移位(15.4%):最初位于气管支气管角(TBA)近端的8根导管中有5根(62.5%)移位,最初位于TBA远端的69根导管中有7根(10.14%)移位。注射前导管的初始位置与移位频率显著相关(P < 0.006)。造影剂注射速率和造影剂用量不是位置改变的危险因素。无并发症发生。

结论

位于TBA上方的PIPICC发生导管移位的比例为62.5%。在注射造影剂前应检查初步的定位图像。此外,建议在注射后扫描定位图像以确认导管位置。

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