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多学科团队在镜像右位心患者中优化经外周中心静脉置管尖端位置:病例报告。

Optimizing the tip position of a peripherally inserted central venous catheter under a multidisciplinary team approach in a patient with mirror-image dextrocardia: a case report.

机构信息

Cancer Center, Daping Hospital, Army Medical University, Chongqing, China.

Department of Respiratory, Daping Hospital, Army Medical University, Chongqing, China.

出版信息

J Int Med Res. 2023 May;51(5):3000605231169432. doi: 10.1177/03000605231169432.

Abstract

Peripherally inserted central venous catheters (PICCs) are widely used in cardiology because they are convenient, effective, and safe. However, PICC implantation in patients with mirror-image dextrocardia who have thoracic tumors has not yet been reported. In this case report, we describe a 46-year-old patient with lung cancer who had a thoracic inclination and left pulmonary artery compression of the superior vena cava. PICC implantation under B-ultrasound guidance was planned. Because of the anatomical differences caused by mirror-image dextrocardia, we investigated the optimal position and measurement method for the tip of the PICC according to the compression site of the vascular lumen through a multidisciplinary team approach. Electrocardiography-assisted tip positioning combined with postoperative chest X-ray positioning was performed for accurate positioning.

摘要

经外周静脉穿刺中心静脉置管(PICC)在心脏病学中应用广泛,因其方便、有效且安全。然而,镜像右位心合并胸部肿瘤患者的 PICC 植入尚未见报道。本病例报告描述了 1 例 46 岁肺癌患者,该患者存在胸腔倾斜和左上腔静脉受压。计划在超声引导下进行 PICC 植入。由于镜像右位心引起的解剖差异,我们通过多学科团队方法,根据血管腔受压部位,研究了 PICC 尖端的最佳位置和测量方法。采用心电图辅助尖端定位,结合术后胸部 X 线定位,实现了准确的定位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bbe5/10164255/fe80cd0d61f3/10.1177_03000605231169432-fig1.jpg

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