影像引导下长期中心静脉导管置入可减少并发症并降低成本。
Image-guided placement of long-term central venous catheters reduces complications and cost.
作者信息
Bowen Megan E, Mone Mary C, Nelson Edward W, Scaife Courtney L
机构信息
Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA.
Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, USA.
出版信息
Am J Surg. 2014 Dec;208(6):937-41; discussion 941. doi: 10.1016/j.amjsurg.2014.08.005. Epub 2014 Sep 22.
BACKGROUND
The goals of this study were to evaluate the complication rate for intraoperative placement of a long-term central venous catheter (CVC) using intraoperative ultrasound (US) and fluoroscopy and to examine the feasibility for eliminating routine postprocedure chest X-ray.
METHODS
Retrospective data pertaining to operative insertion of long-term CVC were collected and the rate of procedural complications was determined.
RESULTS
From January 2008 to August 2013, 351 CVCs were placed via the internal jugular vein using US. Of these, 93% had a single, successful internal jugular vein insertion. The complications included 4 arterial sticks (1.14%). Starting in October 2012, postprocedure chest radiography (CXR) was eliminated in 170 cases, with no complications. A total of $29,750 in charges were deferred by CXR elimination.
CONCLUSIONS
This review supports the use of US for CVC placement with fluoroscopy in reducing the rate of procedural complications. Additionally, with fluoroscopic imaging, postprocedural CXR can be eliminated with associated healthcare savings.
背景
本研究的目的是评估使用术中超声（US）和荧光透视法进行长期中心静脉导管（CVC）术中置入的并发症发生率，并探讨取消术后常规胸部X线检查的可行性。
方法
收集与长期CVC手术置入相关的回顾性数据，并确定手术并发症发生率。
结果
2008年1月至2013年8月，通过超声经颈内静脉置入351根CVC。其中，93%成功单次经颈内静脉置入。并发症包括4次动脉穿刺（1.14%）。从2012年10月开始，170例患者术后未进行胸部X线摄影（CXR），无并发症发生。取消CXR检查共节省费用29,750美元。
结论
本综述支持在荧光透视下使用超声进行CVC置入，以降低手术并发症发生率。此外，借助荧光透视成像，可取消术后CXR检查，并节省相关医疗费用。
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