Application Research Of Ultrasound Oblique Axis Plane Guidance Technique In PICC Puncture

Objective To explore the application efficacy and safety of ultrasound oblique axis plane guidance technique in PICC puncture,in order to provide guidance and reference for clinical application.Methods This study was a randomized controlled trial,in which 654 patients who underwent PICC catheterization with ultrasound guidance technique in a tertiary hospital in Zhejiang Province from March 2022 to December 2022 were randomly divided into three groups:A,B,and C.The short-axis method,long-axis method,and oblique axis method were used for PICC puncture under ultrasound guidance in the three groups,respectively.The success rate of first-time puncture,the number of subcutaneous needle adjustments,puncture time,and the occurrence of puncture complications(hematoma,puncture of the contralateral blood vessel wall,accidental arterial puncture,accidental nerve injury,etc.)were recorded during the catheterization process in the three groups.Results All three groups of patients underwent PICC catheterization with ultrasound guidance combined with Seldinger technique.The success rate of first-time puncture in the C group(86.36%)was higher than that in the A group(73.95%)and the B group(63.93%),and there was a statistically significant difference among the three groups(P<0.001).The average number of subcutaneous needle adjustments in the C group(1.18 times)was less than that in the A group(1.39 times)and the B group(1.5 times),and the Kruskal-Wallis H test results showed that there was a statistically significant difference among the three groups(Z=24.535,P<0.001).The comparison of the oblique axis method in the C group with the short-axis method in the A group and the long-axis method in the B group showed statistically significant differences.There was no statistically significant difference between the short-axis method in the A group and the long-axis method in the B group.The puncture time with the oblique axis method in the C group was shorter than that with the short-axis method in the A group and the long-axis method in the B group,and there was a statistically significant difference among the three groups(Z=74.626,P<0.001).There were statistically significant differences in puncture complications,such as accidental nerve injury and puncture of the contralateral blood vessel wall,among the three groups(P<0.05),but there was no statistically significant difference in accidental arterial puncture and hematoma occurrence.There were statistically significant differences in puncture complications among the three groups.Conclusion The use of ultrasound guidance combined with Seldinger technique for PICC catheterization showed that the oblique axis method was superior to the short-axis method and the long-axis method,which can significantly shorten the puncture time,reduce the number of subcutaneous needle adjustments,improve the success rate of first-time puncture,effectively reduce the occurrence of puncture complications,and ensure the safety of PICC catheterization.It is worthy of promotion.