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頁籤選單縮合
題名 | A Novel Approach of Intravenous Electrocardiograph Technique in Correct Position the Long-Term Central Venous Catheter=靜脈心電圖導引置放方式以正確置放長期靜脈導管 |
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作者 | 程廣義; 朱光興; 余廣亮; 盧偉; 陳慧明; 湯兆舜; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷期 | 16:5 2000.05[民89.05] |
頁次 | 頁241-247 |
分類號 | 415.3023 |
關鍵詞 | 靜脈心電圖; 靜脈導管; Intravenous electrocardiograph; Guide wire; Sodium bicarbonate; Port; |
語文 | 英文(English) |
中文摘要 | 靜脈內心電圖可經由導管的前端趨向右心房時,以心電圖的p波變大來 正確的置放靜脈導管且它是種安全、可信賴及準確的技術。本前瞻性研究包括 216位癌症病人,評估靜脈內心電圖經由導引導線(guide wire)的訊號及訊號經由 port和充滿NaHCO3導管的傳遞效果,再和一般習慣的解剖指標方式做比較。第 一組(n=80)病人以解剖指標位置及攜帶式胸部x光照片確認正確的導管前端位 置;第二組(n=72)病人以導引導線傳遞靜脈內心電圖訊號來確認正確位置;第三 組(n=64)病人以port和充滿NaHCO3導管傳遞靜脈內心電圖訊號來確認正確位 置。三組病人間的特質並無明顯差異。三組病人的手術期間為第一組45.4±9.3 分比第二組35.7±8.0分及第三組 35.2±9.7 分時間長有統計上的意義 (p <0.001)。手術中的導管前端放置時間為第二組5.3 ?2.9分及第三組6.4±3.0分比 第三組的16.7±5.7 分時間短並有統計上的意義 (p <0.001)。然而第二組及第三組 在手術期間和導管前端放置時間,則無明顯差異。三組病人間的早期和三個月內 的晚期併發症並無明顯差異。從以上而推定導引導線傳遞靜脈內心電圖訊號得到 和充滿NaHCO3導管傳遞靜脈內心電圖訊號的相似效果。值得推薦為植入長期中 心靜脈裝置的方式。 |
英文摘要 | IIntravenous electrocardiograph (IVECG) can correctly positioning the catheter tip by enlarging p wave as it is moved toward right atrium, and it is a safe, reliable and accurate technique. To evaluate the efficacy of wire-conducted IVECG signal and IVECG signal from the port with sodium bicarbonate (NaHCO3) flushed catheter and to compare those with conventional anatomy landmark method was the propose of this study. This prospective study was carried out in 216 patients who suffered from malignant diseases. The correct position of the catheter tip among these groups was confirmed as follows. In group 1 (n=80), the anatomy landmark method and portable chest radiograph recognized the correct position. In group 2 (n = 72), IVECG signal was conducted from guide wire to identify the tip position. In group 3 (n=64), IVECG signal was conducted from the port with NaHCO3 (0.8 mEq/mL) flushed catheter to ascertain the tip position. The patient characteristics did not differ significantly among the groups. The duration of operation was significantly (P<0.001) longer in group 1 than in group 2 and group 3 (45.4 ?9.3 minutes vs 35.7 ?8.0 minutes and 35.2 ?9.7 minutes, respectively). Catheter tip placement times were shorter in group 2 and group 3 than in group 1 (5.3 ?2.9 minutes and 6.4 ?3.0 minutes vs 16.7 ?5.7 minutes, respectively); there was a statistically significant difference between the group 1 and group 2 and group 3 (p<0.001). Nonetheless, the duration of operation and catheter tip placement time was similar in group 2 and group 3. Early and late complications within the subsequent 3 months showed no significant difference among groups. We concluded that IVECG signal conducted from guide wire obtained a similar efficiency to that signal from the port with NaHCO3 flushed catheter on positioning the catheter tip of the venous Port-A-Cath system. It is recommended to use these methods to facilitate implanting long-term central venous devices. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。