目的：探讨PICC与锁骨下静脉置管在脑损伤昏迷患者术后置管输液治疗的疗效。方法回顾性分析79例行PICC及63例行锁骨下静脉置管输液治疗的脑损伤昏迷患者的临床资料，比较2种治疗方法的一次性置管成功率及导管置入相关并发症的发生率。结果 PICC一次穿刺成功率94.9％（75／79），锁骨下静脉置管一次穿刺成功率为74.5％（47／63），差异有统计学意义（P＜0.05）；PICC组发生机械性静脉炎、堵管高于锁骨下静脉组（P＜0.05），而导管脱落、非计划性拔管的机率小于锁骨下静脉组（P＜0.05），两组在导管位、导管相关性感染的发生率上差异无统计学意义（ P＞0.05）。结论 PICC与锁骨下静脉置管在脑损伤昏迷患者术后输流治疗中有简单易行、护理方便，留置时长等优点，相比较而言，PICC更具有优势。

Objective To discuss the therapy efficacy of peripherally inserted central catheter ( PICC) and subclavian vein catheter in coma patients with brain injury.Methods A retrospective analysis of the clinical data of coma patients with brain injury, in which 79cases with PICC and 63 cases with subclavian vein catheter.The disposable catheter suc-cess rate and the incidence of catheter -related complications were compared in the two groups.Results A disposable catheter success rate of 94.9%(75/79)in the PICC group, and 74.5%(47/63)in the subclavian vein catheter group , the difference was statistically significant ( P 0.05 ).Conclusions The PICC and subclavian vein catheter used in the coma patients with brain injury has the advantages of simple , convenient nursing , long indwelling time.By comparison , the PICC has mire has more advantages.

目的探讨创伤失血性休克患者锁骨下静脉置管发生相关性感染的原因及防治措施。方法收集创伤失血性休克患者留置锁骨下静脉导管的临床资料，按置管时间长短分析各组感染率及感染菌株。结果336例患者锁骨下静脉置管平均时间4．3d，其中27例发生感染，感染率为8．04％。经积极治疗后所有患者均治愈出院，无死亡病例。结论创伤失血性休克患者行锁骨下静脉置管是安全、有效的，针对其感染危险因素，改善治疗及临床护理，缩短置管时间，可以有效防止置管感染。

Objective To investigate the causes and preventive measures of subclavian venous catheter-related infections oc-curred in traumatic hemorrhagic shock patients .Methods 336 traumatic hemorrhagic shock patients indwelling subclavian vein catheter was included to explore the causes and treatment of catheter-related infections .The outcome was infect rate and strains dis-trubtion .Results Of 336 patients with subclavian vein catheterization average time was 4 .3 days ,including 27 cases of infection , and the infection rate was 8 .04% .All patients were discharged after active treatment ,with no deaths .Conclusion Traumatic hem-orrhagic shock patients with subclavian vein catheter are safe and effective .Risk factors for infection ,improve treatment and patient care ,shorten the time of catheter ,can effectively prevent catheter infections .

目的通过恶性肿瘤患者经外周置入中心静脉导管(PICC)及锁骨下静脉穿刺置管的护理观察,寻求更适宜恶性肿瘤患者化疗的静脉置管方法。方法观察比较2010年12月—2012年6月期间在我院接受PICC置管术化疗的60例患者和60例锁骨下静脉置管患者一次穿刺置管成功率、留置时间、并发症发生率。结果PICC组一次穿刺置管成功率为95%,锁骨下静脉置管组一次穿刺置管成功率为75%,2组比较差异有统计学意义(P0.01);PICC组导管留置时间平均(111±18)d,锁骨下组留置时间平均(28±6)d,锁骨下穿刺组留置时间明显少于PICC组(P0.01);2组并发症的发生率比较差异无统计学意义(P0.05)。结论 PICC技术在临床上的广泛应用,不仅可以减少化疗药物渗透、感染及患者反复穿刺的痛苦,而且可以提高护士的工作效率,保留时间长,是一种可靠有效的静脉治疗途径,与锁骨下静脉穿刺置管比较具有更大的优越性。

ObjectiveTo malignant tumor patients with peripherally inserted central catheter(PICC)tube nursing observation and subclavian vein puncture,tube method to seek more suitable for chemotherapy in patients with malignant tumor of the vein.MethodsRetrospective analysis of 2010 December to 2012 June 60 cases received PICC catheter chemotherapy and 60 cases of subclavian vein catheterization in patients in our hospital. More than,age,disease, chemotherapy in two groups of gender,no significant difference(P>0.05),with comparable.ResultsIn PICC group, one time puncture success rate of 95%,subclavian vein puncture success rate was 75% times of puncture,the two groups had significant difference(P 0.05).ConclusionPICC technology widely used in clinical,and reduce the pain of chemotherapy drug permeation,infection and repeated puncture,but also improve the working efficiency of the nurses,the retention time is long,is a reliable and effective approach to the treatment of the vein,compared with PIC

目的比较两种穿刺入路方式中心静脉置管术在危重症抢救中的应用,寻求适用于危重症患者抢救中最优的中心静脉置管入路方式。方法回顾性分析2008年3月至2013年3月我中心900例危重抢救患者中心静脉置管术临床资料,其中采取颈内静脉穿刺入路方式420例,锁骨下静脉穿刺入路方式480例,通过对两种穿刺入路方式中心静脉置管术在快速穿刺成功率及穿刺相关并发症发生率方面进行分析比较。结果一针穿刺成功率:颈内静脉穿刺入路方式336例(80%);锁骨下静脉穿刺入路方式456例(95%);穿刺相关并发症发生率:颈内静脉穿刺入路方式69例(16.4%),锁骨下静脉穿刺入路方式20例(4.2%)。结论在危重症抢救中锁骨下静脉穿刺入路方式中心静脉置管术在快速穿刺成功率及穿刺相关并发症发生率方面优于颈内静脉穿刺入路方式。

Objective To compare two kinds of puncture approach ways of central vein catheterization in the critically ill rescue application, in the way of central vein to seek for optimal rescue critically ill patients. Methods A retrospective analysis from 2008 March to 2013 year in March 900 cases of critically ill patients in our center of central venous catheterization patients clinical data, which take the internal jugular vein puncture approach in 420 cases, puncture of subclavian vein approach in 480 cases, based on the two kinds of puncture approach ways of central vein catheterization occurred in quick puncture success rate and puncture related complications rate analysis. Results The success rate of puncture of internal jugular vein puncture ap-proach: 336 cases (80% ); puncture of subclavian vein approach in 456 cases (95% ); the incidence rate of puncture related complications: internal jugular vein puncture approach in 69 cases (16. 4% ), puncture of subclavian vein in 20 cases (4.

目的研究不同途径中心静脉置管(CVC)的患者发生感染率比较,从而选择更好的静脉置管方式,降低医院感染率。方法选择手术室2012年行颈内静脉置管、颈外静脉置管、锁骨下静脉置管及股静脉置管的190例患者进行回顾性对比分析,并给予相关性感染的预防措施。结果颈内静脉置管患者80例,感染4例,感染率为5.0%;颈外静脉置管患者26例,感染2例,感染率为7.7%;锁骨下静脉置管患者54例,感染2例,感染率为3.7%;股静脉置管患者20例,感染10例,感染率为50.0%;置管期间出现感染最早是股静脉置管,且置管时间越长,置管感染率越高。结论不同途径中心静脉置管的患者发生感染率比较,锁骨下静脉置管发生感染率最低,其次是颈内静脉置管,故而选择锁骨下静脉置管及颈内静脉置管可有效降低医院感染率。

OBJECTIVE To compare the infection rate of different ways of central venous catheterization (CVC) ,so as to choose a better method for CVC and reduce the infection rate in hospital .METHODS A total of 190 patients with internal jugular vein catheterization ,external jugular vein catheterization ,subclavian vein and femoral vein catheterization was chosen in 2012 for the retrospective study ,and infection prevention measures were provided . RESULTS Among the 80 cases of internal jugular vein catheterization patients ,4 cases with infection ,accounting for 5 .0% ;there were 26 cases of external jugular vein catheterization ,among which 2 cases were with infection , accounting for 7 .7% ;there were 54 cases got subclavian vein catheterization ,2 cases with infection ,accounting for 3 .7% ;there were 20 cases of femoral vein catheterization ,10 with infection ,accounting for 50 .0% ;femoral vein catheterization was the first to have infection and the longest catheter time ,the higher the i