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崔顺悦,厉燕.PICC导管应用于3例新冠肺炎危重症患者的护理[J].上海护理,2022,22(S1):
PICC导管应用于3例新冠肺炎危重症患者的护理
The nursing care of PICC practice in critically ill COVID-19 patients
DOI：
中文关键词:  新型冠状病毒肺炎  PICC  抗凝  超声引导  重症患者
英文关键词:Coronavirus (COVID-19), PICC, anticoagulation, ultrasound, critically  ill patients
基金项目:
作者单位E-mail
崔顺悦 上海交通大学医学院附属仁济医院 418051321@qq.com 
厉燕* 上海交通大学医学院附属仁济医院 haohao20051210@163.com 
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中文摘要:
      本文回顾了三例危重症新冠肺炎患者,在重症监护隔离病房应用经外周置入中心静脉导管 (Peripherally inserted central catheter, PICC)的经验,包括重症患者应用PICC的指征、穿刺点的选择、穿刺的技巧、穿刺后的维护、抗凝状态下PICC的相关并发症。我们认为,包括新冠肺炎在内的、尤其是接受持续抗凝的重症患者,PICC可作为中心静脉通路的首选方案；术前详尽的超声血管评估和穿刺时正确的超声引导能够提高多重个人防护下的穿刺成功率；在不能停止抗凝的极端情况下,护理PICC相比CVC更加便捷,一旦出现穿刺点渗血等并发症,也能相对简单有效地进行处理。综上所述,我们推荐PICC在重症患者中有指征地应用,尤其是需要持续抗凝的患者中,充分发挥PICC的优势,有技巧地使用超声定位和引导,通过护理手段减少和处理PICC相关并发症。
英文摘要:
      The experience of inserting peripherally inserted central catheter (PICC) to three critically ill patients with coronavirus (COVID-19) in the quarantine intensive care unit is reviewed in this article, including the indications of inserting PICC to critically ill patients, the choice of insertion spots, the skills of cannulation, the maintenance care of the PICC access, the complications of using PICC under anticoagulant therapy. It is considered that PICC can be the preferred central venous access for critically ill patients with COVID-19, especially these under continues anticoagulant therapy; the use of ultrasound before and during the insertion can improve the success rate of insertion while using personal protective equipment; the maintenance care of PICC is easier than the care of CVC under the circumstances of unstoppable anticoagulant therapy; Possible complications such as inserting spot bleeding are easier to be managed in the case of PICC than in the case of CVC. In conclusion, PICC is recommended to use among the critically ill patients with indications, especially these under anticoagulant therapy. It is recommended to take the advantage of PICC, use ultrasound to locate the spot and guide the insertion, prevent and reduce the complications of PICC with appropriate nursing care.
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