Discussion on the application effect of different tip positions of the modified medium-length catheter
改良中等长度导管不同尖端位置应用效果探讨

摘要

目的 探讨改良中等长度静脉导管尖端位于不同位置的临床应用效果。方法 选取自2022年1月至2022年12月进入我院接受治疗的120例改良中长导管置管患者为本次的研究对象。置管后对他们实施常规的胸部正位片确定导管尖端位置，并根据导管的尖端位置将其将其分为锁骨下静脉组、头臂干静脉组和胸壁段腋静脉组三组。然后分别对三组导管存在的并发症（如导管所致的静脉炎、相关性血栓、感染、渗血和导管堵塞等）发生率、非计划拔管率、导管留置时间进行对比。结果 试验组和对照组的导管相关并发症总发生率分别为9.93%、14.63%,并发症拔管率分别为2.13%、4.07%，P＜0.05，具备统计学意义。并发症所致的拔管率明显比对照组低，差异明显，具有统计意义，且试验组及对照组在导管的留置时间上，数据也有明显差异，具有统计学意义（P<0.017）。结论 改良中等长度静脉导管尖端位于锁骨下静脉和头臂静脉干时，导管相关并发症发生率较低,留置时间较长，综合分析来看，更适宜临床应用。

Abstract

Objective: To explore the clinical application effect of improving the tip of medium length venous catheters at different positions. Method Convenience: 120 patients with modified medium and long catheterization in our hospital from January 2022 to December 2022 were selected as the study subjects. After catheterization, a routine chest X-ray was performed to determine the position of the catheter tip. According to the position of the catheter tip, it was divided into three groups: subclavianvein group, brachiocephalic trunk vein group, and chest wall axillary vein group. Compare the incidence rate, unplanned extubation rate, and catheter retention time of complications such as catheter induced phlebitis, related thrombosis, infection, bleeding, and catheter blockage among the three groups of catheters. The total incidence of catheter related complications in the experimental group and the control group were 9.93% and 14.63%, respectively, and the extubation rates of complications were 2.13% and 4.07%, with P<0.05, indicating statistical significance. The extubation rate caused by complications is significantly lower than that of the control group, with significant differences and statistical significance. Moreover, there is a significant difference in the retention time of the catheter between the experimental group and the control group, with statistical significance (P<0.17).
Conclusion  : When the tip of the modified medium length venous catheter is located in the subclavian vein and brachiocephalic vein trunk, the incidence of catheter related complications is lower, the retention time is longer, and it is more suitable for clinical application.