Zhu Li-Bo, Liu Ling, Zhang Tie-Song, Zheng Yu-Ting, Lu Chun-Yan, Lu Kun, Zhang Shu-Xian, Duan Liu-Yan, Yang Mei-Lin
Department of Neonatology, Kunming Children's Hospital, Kunming, China.
Transl Pediatr. 2021 Oct;10(10):2409-2417. doi: 10.21037/tp-20-370.
The present study aimed to investigate the P-wave changes in intracavitary electrocardiography (IC-ECG) during catheterization with a peripherally inserted central catheter (PICC) in order to provide guidance for the accurate localization of the tip of the PICC.
A total of 106 newborns who needed a PICC were randomly divided into two groups-a study group and a control group-using a random number table, with 53 cases in each group. In the study group, the ECG monitor was connected after the successful puncture and insertion of the PICC into the right sternoclavicular joint, and the position of the catheter tip was determined according to the P-wave changes on the IC-ECG. Localization X-rays were taken at the same time. In the control group, after the successful routine puncture and insertion of the PICC into the location to a predetermined length, localization X-rays were taken. The accuracy, procedure duration, and cost of the two localization methods were evaluated.
The accuracy of the localization in the study group was 92.5%, but the difference was not significant when compared with the control group (P>0.05). The duration of the procedure in the study group was 5.12±1.57 minutes, and the cost was 7.12±0.56 yuan, both of which were significantly different when compared with the control group (P<0.05).
P-wave changes during IC-ECG have high accuracy in determining the location of the tip of the PICC. It is also a simple method and has certain clinical application value.
Chinese Clinical Trial Registry (number: ChiCTR2100047660).
本研究旨在探讨经外周静脉穿刺中心静脉置管（PICC）过程中腔内心电图（IC-ECG）的P波变化，为PICC尖端的准确定位提供指导。
采用随机数字表法将106例需要行PICC的新生儿随机分为研究组和对照组，每组53例。研究组在PICC成功穿刺并插入右胸锁关节后连接心电监护仪，根据IC-ECG上的P波变化确定导管尖端位置，同时拍摄定位X线片。对照组在PICC常规穿刺成功并插入至预定长度后拍摄定位X线片。评估两种定位方法的准确性、操作时间和费用。
研究组定位准确率为92.5%，与对照组相比差异无统计学意义（P>0.05）。研究组操作时间为5.12±1.57分钟，费用为7.12±0.56元，与对照组相比均有显著差异（P<0.05）。
IC-ECG过程中的P波变化在确定PICC尖端位置方面具有较高的准确性，也是一种简单的方法，具有一定的临床应用价值。
中国临床试验注册中心（编号：ChiCTR2100047660）。
