Riblet J L, Shillinglaw W, Goldberg A J, Mitchell K, Sedani K H, Davis F E, Reynolds H N
Maryland Institute for Emergency Medical Services Systems, Baltimore, USA.
Am Surg. 1996 Dec;62(12):1064-5.
The Seldinger technique is commonly used to change central venous access catheters in the Intensive Care Unit. These catheters are routinely being changed to prevent septic complications. Some of these changes are performed by an "over-wire" technique. To assess the utility of postprocedural chest X-rays on critically ill patients after an over-wire catheter change, we followed 68 patients after they had 80 catheter changes. This study assesses catheter position by use of a postprocedural X-ray. During the study, we found no misplaced catheters and minimum symptomatology in 80 patients. The trauma/critical care fellows performing the procedures rated them as easy in 97.5 percent of the changes. The conclusion of the study is that, if the catheter change is technically easy and the patient has no symptoms, a postprocedural X-ray is not necessary.
在重症监护病房，常采用Seldinger技术更换中心静脉置管。这些导管需定期更换以预防感染并发症。部分更换操作采用“导丝交换”技术。为评估导丝交换导管后对重症患者进行术后胸部X线检查的作用，我们对68例患者进行了80次导管更换操作，并对其进行了随访。本研究通过术后X线评估导管位置。研究期间，我们发现80例患者中无导管位置不当情况，且症状轻微。进行操作的创伤/重症监护专科住院医师认为，97.5%的更换操作很容易。研究结论为，如果导管更换操作在技术上很容易且患者无症状，则无需进行术后X线检查。
