Application of ultrasonic guidance combined with modified seldinger technique in peripherally inserted central catheter from upper arm vein

Objective To investigate the clinical applications and safety of ultrasonic guidance combined with modified seldinger technique in peripherally inserted central catheter(PICC) from upper arm vein. Methods 100 patients given PICC by ultrasonic guidance combined with modified seldinger technique from January 2010 to December 2013 in the Center Hospital Affiliated to Shenyang Medical College were selected as observation group, and in the same time, 100 cases given the conventional puncture were selected as control group. The bleeding loss during the catheterization, catheter indwelling time, basilic vein and other veins usage, elbow up/down puncture applicable conditions, cannulation success rate and complications incidence of two groups were observed and compared. Results The elbow up/down puncture catheterization utilization rate of two groups were compared, the difference was statistically significant(P 0.05). In observation group, the elbow up/down applicable puncture were 96 and 100 cases, and in control group those were 11 cases and 66 cases, the applicable rate of observation group was higher, the difference was statistically significant(P 0.05). The catheter indwelling time of observation group and control group were(195±18),(136±14) d, the difference was statistically significant(P 0.05); the basilic vein used in observation group and control group were 89 and 62 cases, the difference was statistically significant(P 0.05). The once catheterization success rate of observation group and control group were 93.0% and 56.0%, the difference was statistically significant(χ2= 11.082, P 0.05); the total catheterization success rate of observation group and control group were 100.0% and 76.0%, the difference was statistically significant(χ2= 9.129, P 0.05). The incidence of complications of observation group and control group were 4.0% and 13.0%. Conclusion Color Doppler ultrasonic guidance combined with modified seldinger technique can greatly improve the success rate of PICC from upper arm vein, reduce catheter complications, increase catheters indwelling time, it is worthy of clinical promotion.