PICC导管头端定位与并发症处理_培训课件.ppt

哪一个是透视的图像，哪一个是胸片的图像？ * Peripherally inserted central catheters (PICCs) have become popular for long courses of intravenously administration of antibiotics. Although these devices are generally regarded as safe, thrombotic complications have been associated with their use. In a retrospective review, 51 (2.47%) of 2063 patients who had a PICC placed during 1994–1996 were found to have developed a total of 52 PICC-associated venous thromboses (VTs). Two patients received the diagnosis of pulmonary embolism that was a complication of VT. Risk factors for VT identified by multiple logistic regression analysis were younger age, history of VT, discharge to a skilled-nursing facility, and therapy with amphotericin B. VT is a significant complication of PICC placement. It may occur more frequently than previously recognized and may be complicated by pulmonary embolism. Clinicians should maintain a high index of suspicion, especially for high-risk patients. * The brand of PICCs used in our institution during the study period was Per-Q-Cath (Bard), a single-lumen catheter. The sizes of these catheters were 3.0 Fr or 4.0 Fr. PICCs were inserted by members of a team of registered nurses, known as the “PICC team,” each of whom had been trained in the same technique of insertion. Strict aseptic conditions were used during each procedure: sterile gloves, gowns, and face masks were worn, and careful skin cleaning and draping of the procedure area were performed. Chest radiography was done to ensure proper tip location after the procedure was completed. All patients who were receiving intravenously administered antibiotics via PICC were followed up in the outpatient division of the infectious diseases department. Indications for PICC placement included soft-tissue and bone infections (for 35% of placements), endocarditis and bloodstream infections (for 15% of placements), intra-abdominal infections (for 9% of placements), and cytomegalovirus prophylaxis or viremia (for 8% of placem