Cause analysis and nursing countermeasure of misdiagnosis of PICC catheter internal carotid vein in 32 cases

Yuwei Wang, Xiao Hu
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Abstract

Objective: To analyze the causes of missed diagnosis and improve nursing countermeasures in patients with PICC catheterization of internaljugular vein. Methods: We conducted a retrospective study of 32 patients who weren’t diagnosed ectopic catheterizations of internal jugularvein until they had X-ray examinations after ultrasound guided PICC catheterization. We analyzed the reasons of missed diagnosis to providea certain guidance for clinical practices. Results: The missed diagnosis of ectopic catheterizations of internal jugular vein were caused bysmall exploratory area of internal jugular vein, improper usage of ultrasonic probe, operation step missing, variations of veins and so on. Thefirst two reasons are the main factors. Conclusion: In order to reduce the occurrence of missed diagnosis of ectopic PICC catheterizations ofinternal jugular vein, the operators should expand the exploratory area of internal jugular vein, use the ultrasonic probe correctly, improve theoperation level, follow the operation procedure strictly and evaluate patients’ preoperative situations carefully. If all the measures above aretaken, we can assuredly reduce the rate of missed diagnosis of ectopic PICC catheterizations of internal jugular vein.
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PICC导管颈内静脉32例误诊原因分析及护理对策
目的:分析颈内静脉PICC置管的漏诊原因,提出护理对策。方法:回顾性分析32例经超声引导PICC置管后行x线检查才被诊断为颈内静脉异位置管的患者。分析漏诊原因,为临床实践提供一定的指导。结果:颈内静脉异位置管漏诊主要是由于颈内静脉探查面积小、超声探头使用不当、手术步骤缺失、静脉变异等原因。前两个原因是主要因素。结论:为减少颈内静脉异位PICC置管术的漏诊率,术者应扩大颈内静脉探查面积,正确使用超声探头,提高手术水平,严格按照手术流程操作,认真评估患者术前情况。如果采取以上措施,一定可以降低颈内静脉异位PICC置管的漏诊率。
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