Abstract:

Objective To explore the optimal method for guiding totally implantable access port via upper arms using intracavitary electrocardiogram.Methods One hundred and ten patients were enrolled and randomly divided into the guide wire conducting group and the normal saline conducting group. Occurrence rate of P wave with characteristics,stability of electrocardiogram,accuracy of catheter tip position,satisfaction of medical staff and length of operation were compared between two groups.Results The intracavitary electrocardiograms were caught in all patients and were stable,the catheter tip position was located in the inferior 1/3 segment of the superior vena cava. The occurrence rate of P wave with characteristics in the guide wire conducting group was significantly higher than that in the normal saline conducting group（P=0.028）. The satisfaction of medical staff in the normal saline conducting group was significantly higher,and length of operation in the normal saline conducting group was significantly shorter than the guide wire conducting group（P<0.001）.Conclusion Both methods can obtain intracavitary electrocardiogram,P wave with characteristic can be easily obtained in the guide wire conducting group,whereas the operation process is more convenient in the normal saline conducting group.

Key words: Intracavitary Electrocardiogram, Upper Arm Totally Implantable Access Port, Tip Position, Basic Nursing Care

摘要：

目的 探讨生理盐水导电法与导丝导电法引导腔内心电图定位技术在经上臂静脉植入输液港中的应用效果。方法 选择行经上臂静脉输液港植入术的患者110例,随机分成生理盐水导电组和导丝导电组,比较两种方式腔内心电图定位的特征性P波出现率、心电图的稳定性、导管尖端到位准确率、医护满意度和手术时间。结果 所有患者在经上臂静脉输液港植入术中均能引导出稳定的腔内心电图,且导管尖端均位于上腔静脉的下1/3段。导丝导电组特征性P波出现率显著高于生理盐水导电组（P=0.028）。生理盐水导电组医护满意度显著高于导丝导电组（P<0.001）,患者的阶段手术时间较短（P<0.001）。结论两种方法均能引导出腔内心电图,导丝导电组更易获得标准型P波,生理盐水导电组操作流程的便捷性更高。

关键词: 腔内心电图, 上臂静脉输液港, 尖端位置, 基础护理