中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (03): 201-203.doi: 10.3969/j.issn.1671-4091.2017.03.015

• 血管通路 • 上一篇    下一篇

超声造影在确认带隧道和涤纶套的导管尖端位置的应用

赵现伟1,王志芳2,杨亚东3,张玲2,谢斌1,李益明2   

  1. 黄冈市中心医院1超声科, 2肾内科, 3重症医学科
  • 收稿日期:2016-08-16 修回日期:2016-12-12 出版日期:2017-03-12 发布日期:2017-03-12
  • 通讯作者: 王志芳 longwzf@yahoo.com E-mail:longwzf@yahoo.com
  • 基金资助:

    湖北省卫生和计划生育委员会资助项目WJ2015MB271

Contrast enhanced ultrasonography to identify the tip position of tunneled cuffed catheter

  • Received:2016-08-16 Revised:2016-12-12 Online:2017-03-12 Published:2017-03-12

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摘要： 目的探讨超声和超声造影(contrast enhanced ultrasound，CEUS)技术在确认带隧道和涤纶套的导管(tunneled cuffed catheter，TCC)尖端的位置的作用。方法对45 例透析患者根据传统体表定位法和Seldinger 法，在超声实时引导下穿刺，置入TCC 导管。术后常规超声剑突下心腔四切面直接观察导管尖端位置。对于不能确认管尖位置的则进行导管内CEUS 再次确认。对于导管尖端未达目标位置，即时调整导管尖端至目标位置。术毕行胸片检查作对比。结果常规超声导管尖端识别率77.8%(35/45 例)，剩余10 例行CEUS，识别率提高至100%。导管尖端一次性到达目标位置比率(62.2%)，剩余需要重新调整管尖位置。结论超声或CEUS 可实时确定导管尖端位置，从而达到精确放置TCC 导管的效果。本法具有安全、快速、准确、方便和无辐射等优点，值得推广。

关键词: 超声造影, 带隧道和涤纶套的导管, 尖端位置

Abstract: Objective To explore the usefulness of conventional ultrasonography and contrast enhanced ultrasonography (CEUS) to identify the tip position of tunneled cuffed catheter (TCC). Methods A total of 45 patients were subjected to TCC placement under the guidance of body landmark and Seldinger’s techniques and beside real-time ultrasonography. After insertion of the catheter, conventional ultrasonography via subxiphoid cardiac view was used to observe the tip position. If the catheter tip was not visible on conventional ultrasonography, CEUS was performed to further confirm the catheter tip position. If the catheter tip was not in its target position, prompt adjustment was made. After the manipulation, a chest radiograph was made to reconfirm the tip positioning. Results Conventional ultrasonography identified the catheter tips in 77.8% (35/45) patients, and CEUS identified the tip position in the remaining 10 patients. Only 62.2% catheter tips located at the target position at the first attempt, and adjustment of the catheter tips was required in the remaining patients. Conclusions Conventional ultrasonography combined with CEUS can accurately and promptly identify the tip position of TCC. This method is safe, accurate, time-saving, convenient and free of radiation. We recommend its use following TCC insertion.

Key words: Contrast enhanced ultrasonography, Tunneled cuffed catheter, Tip position