EICU, The First People's Hospital of Wenling, Wenling, China.
The First People's Hospital of Wenling, Wenling, China.
Medicine (Baltimore). 2024 Jun 7;103(23):e38372. doi: 10.1097/MD.0000000000038372.
To explore the clinical application value of intracavitary electrocardiogram (ECG) localization combined with ultrasound in central venous catheterization in critically ill patients. A total of 103 patients who were treated in the intensive care unit of our hospital from October 2020 to June 2023 were selected as the study subjects, and according to the differences in their central venous catheter placement methods, they were divided into study group (n = 52, receiving ultrasound combined with intracavitary ECG localization for catheterization) and control group (n = 51, receiving routine catheterization). The differences in the catheter placement accuracy, catheter depth, catheter placement duration, incidence of catheter-related complications, length of stay, and hospitalization expenses between the 2 groups were compared. The analysis utilizing X-ray for catheter tip positioning indicated that the catheter tip placement rate was higher in the study group than in the control group, and the catheter tip malposition rate was lower than in the control group (P < .05). There was no statistical significance in the catheter depth between study group and control group (P > .05), and the catheter placement duration of study group was significantly lower than that of control group, with statistical significance (P < .05). One case of partial catheter blockage, one case of catheter-related bloodstream infection, and one case of phlebitis were observed in study group, with an overall incidence of complications of 5.77% (3/52), which was significantly lower than 21.57% (11/51) of control group (P < .05). The length of stay and hospitalization expenses in study group were significantly lower than those in control group, with statistical significance (P < .05). The combined use of ultrasound and intracavitary ECG localization in critically ill patients undergoing central venous catheterization can help increase the success rate of catheter placement, shorten the catheter placement duration, reduce the incidence of various catheter-related complications, and also reduce the length of stay and hospitalization expenses.
探讨心腔内心电图（ECG）定位联合超声在危重症患者中心静脉置管中的临床应用价值。选取 2020 年 10 月至 2023 年 6 月我院重症监护病房收治的 103 例患者为研究对象，根据中心静脉置管方法的不同分为研究组（n=52，行超声联合心腔内 ECG 定位置管）和对照组（n=51，行常规置管）。比较两组患者的置管准确率、导管深度、置管时间、导管相关并发症发生率、住院时间和住院费用。X 线透视下对导管尖端定位分析，研究组导管尖端位置准确率高于对照组，尖端位置不良率低于对照组（P<0.05）。研究组与对照组的导管深度比较，差异无统计学意义（P>0.05），研究组置管时间明显短于对照组，差异有统计学意义（P<0.05）。研究组发生部分导管堵塞 1 例、导管相关性血流感染 1 例、静脉炎 1 例，并发症总发生率为 5.77%（3/52），明显低于对照组的 21.57%（11/51）（P<0.05）。研究组的住院时间和住院费用明显低于对照组，差异有统计学意义（P<0.05）。超声联合心腔内 ECG 定位在危重症患者中心静脉置管中应用，可提高置管成功率，缩短置管时间，降低各种导管相关并发症的发生率，同时还可降低住院时间和住院费用。
