Nakamuta Soshi, Nishizawa Toshihiro, Matsuhashi Shiori, Shimizu Arata, Uraoka Toshio, Yamamoto Masato
1 Department of Gastroenterology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
2 Division of Cardiology, JCHO Tokyo Takanawa Hospital, Tokyo, Japan.
J Vasc Access. 2018 Nov;19(6):609-614. doi: 10.1177/1129729818765057. Epub 2018 Mar 21.
: Malposition of peripherally inserted central catheters placed at the bedside is a well-recognized phenomenon. We report the success rate of the placement of peripherally inserted central catheters with ultrasound guidance for tip positioning and describe the knacks and pitfalls.
: We retrospectively reviewed the medical case charts of 954 patients who received peripherally inserted central catheter procedure. Patient clinical data included success rate of puncture, detection rate of tip malposition with ultrasonography, adjustment rate after X-ray, and success rate of peripherally inserted central catheter placement.
: The success rate of puncture was 100% (954/954). Detection rate of tip malposition with ultrasonography was 82.1% (78/95). The success rate of ultrasound-guided tip navigation was 98.2% (937/954). The success rate of ultrasound-guided tip location was 98.0% (935/954). Adjustment rate after X-ray was 1.79% (17/952). The final success rate of peripherally inserted central catheter placement was 99.8% (952/954).
: Ultrasound guidance for puncturing and tip positioning is a promising option for the placement of peripherally inserted central catheters. Ultrasound guidance could dispense with radiation exposure and the transfer of patients to the X-ray department.
床边放置的外周静脉穿刺中心静脉导管（PICC）位置不当是一种广为人知的现象。我们报告了在超声引导下进行外周静脉穿刺中心静脉导管尖端定位的成功率，并描述了其中的技巧与陷阱。
我们回顾性分析了954例行外周静脉穿刺中心静脉导管置管术患者的病历。患者临床资料包括穿刺成功率、超声检查发现的尖端位置不当发生率、X线检查后的调整率以及外周静脉穿刺中心静脉导管置管成功率。
穿刺成功率为100%（954/954）。超声检查发现尖端位置不当的发生率为82.1%（78/95）。超声引导下尖端导航成功率为98.2%（937/954）。超声引导下尖端定位成功率为98.0%（935/954）。X线检查后的调整率为1.79%（17/952）。外周静脉穿刺中心静脉导管置管最终成功率为99.8%（952/954）。
超声引导穿刺和尖端定位是外周静脉穿刺中心静脉导管置管的一种有前景的选择。超声引导可避免辐射暴露以及患者转运至放射科。
