- 期刊
An Alternative Technique for Accurate Placement of Central Venous Catheter Tips
另一種正確置放中央靜脈導管的選擇
摘要
金屬管絲(Wire stylet)常被用為心電圖探針，並以靜脈心電圖技術來正確置放中央靜脈導管。我們提出另一種技術，以轉導探針(transduction probe)連接右臂心電圖導線，再和以金屬線傳導心電圖的技術方式，做功效及靜脈心電圖訊號品質的比較。依隨機將60位患者分為G(n =30)及T(n=30)兩組。在G組中，靜脈心電圖訊號由金屬導線傳導來確定正確的導管頂端位置。在T組中，靜脈心電圖訊號由轉導探針傳導正確導管頂端位置。以連續10秒心電圖基準線漂移程度，P波圖形及QRS波圖形的清晰狀況作為靜脈心電圖訊號傳導品質的評估。結果發現，兩組在確定正確的導管頂端位置的置放時間及測量出的最理想導管長度，並無照顯差異。G組在操作過程中心律不整的發生率較T組高，然而並不具統計意義(P=0.09)。在得到令人滿意的靜脈心電圖訊號品質結果方面，G組有26位，T組有27位。因此，我們認為轉導探針亦能有效的傳遞靜脈心電圖訊號且不需特殊工具，它是種可供選擇的技術用來正確放置中央靜脈導管。
並列摘要
For intravenous electrocardiography (IVECG), a wire stylet is usually utilized as the exploring probe to correctly position the central venous catheter. We present an alternative technique using the transduction probe connected to the original right arm lead of the ECG monitor to accurately position the central venous catheter. We compared the efficacy and quality of the IVECG signals of the two techniques. Sixty patients were randomly enrolled into two groups. In group G, the IVECG signal was conducted from the guide wire to identify the correct catheter tip position. In group T, the IVECG signal was conducted from the transdution probe to ascertain the tip position. The quality of IVECG signals, which included baseline drift, P-wave pattern, and QRS wave pattern, were assessed for 10 seconds. There was no obvious difference between the groups for catheter tip placement time or measured optimal catheter length. During manipulation, the incidence of cardiac dysrhythmia was higher in group G than in group T, but the difference was not significantly different (p=0.09). Satisfactory IVECG signal quality was observed in 26 of the 30 patients in group G and in 27 of the 30 patients in group T. We conclude that the transduction probe can effectively conduct IVECG signals with no specific additional equipment required. It is an alternative technique for accurate placement of central venous catheter tips during IVECG.
延伸閱讀
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