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腔内心电图定位在预防肿瘤患儿 PICC 异位中的临床意义。

Clinical significance of intracavitary electrocardiographic localization in the prevention of PICC heterotopia in children with tumor.

机构信息

Department of Central Venous Catheter Clinic, Shijiazhuang People's Hospital, Shijiazhuang, China.

Shijiazhuang People's Hospital, Shijiazhuang, China.

出版信息

Ann Noninvasive Electrocardiol. 2022 Jul;27(4):e12934. doi: 10.1111/anec.12934. Epub 2022 Apr 28.

Abstract

OBJECTIVE

To explore the clinical significance of intracavitary electrocardiogram positioning technology in preventing catheter ectopic position during peripherally inserted central catheter (PICC) catheterization in children with tumors.

METHODS

A retrospective analysis of the clinical data of 62 children who required PICC catheterization was performed. The intracavitary electrocardiogram (ECG) positioning technology was used during the tube placement of the child patients. After the tube was successfully placed, the chest radiograph was taken. The ECG positioning result was compared with the chest radiograph positioning result after the tube was inserted, and the sensitivity and specificity of the ECG positioning were calculated.

RESULTS

The intracavitary electrocardiogram results of 62 children with PICC catheters showed that 56 cases (90.32%) had characteristic P waves, and six cases (9.68%) had no characteristic P waves. The chest radiographs of 56 children with characteristic P wave showed that 33 cases (58.93%) of the catheter tip position was appropriate, 22 cases (39.29%) of the catheter tip was too deep, and 1 case was in a non-superior vena cava; six cases of chest radiographs of children with no characteristic P wave showed: one case was too deep at T8 level, one case was too shallow at T4 level, four cases were at non-superior vena cava, one case was contralateral internal jugular vein, two cases in the contralateral brachiocephalic vein, and one case was the contralateral subclavian vein.

CONCLUSION

Intracavitary ECG positioning assisted catheter placement in infants can effectively improve the accuracy of catheter tip position.

摘要

目的

探讨腔内心电图定位技术在预防肿瘤患儿经外周静脉穿刺中心静脉置管(PICC)置管过程中导管异位的临床意义。

方法

回顾性分析 62 例行 PICC 置管术患儿的临床资料,对患儿置管时采用腔内心电图(ECG)定位技术,置管成功后摄胸部 X 线片,将 ECG 定位结果与置管后胸部 X 线片定位结果进行比较,计算 ECG 定位的灵敏度和特异度。

结果

62 例 PICC 置管患儿腔内 ECG 结果显示,56 例(90.32%)有特征性 P 波,6 例(9.68%)无特征性 P 波。56 例有特征性 P 波的患儿胸部 X 线片显示,导管尖端位置合适 33 例(58.93%),导管尖端过深 22 例(39.29%),1 例不在上腔静脉内;6 例无特征性 P 波的患儿胸部 X 线片显示:1 例 T8 水平过深,1 例 T4 水平过浅,4 例不在上腔静脉内,1 例在对侧颈内静脉,2 例在对侧头臂静脉,1 例在对侧锁骨下静脉。

结论

腔内 ECG 定位辅助婴幼儿导管放置可有效提高导管尖端位置的准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7b2/9296801/f3d5dee65549/ANEC-27-e12934-g002.jpg

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