一例PICC导管在体内断裂的病例分析

A Case Analysis of PICC Catheter Rupture in Vivo

摘要: 卫健委发布的《静脉治疗护理技术操作规范》明确表示PICC适用于中到长期的静脉治疗，并且可以用于各种类型的药物输注。PICC置管技术具有简单安全的操作方式、避免多次穿刺、可降低化疗药物或高渗性液体对血管的伤害、便于放置、高度的安全性和便于携带等多种优势。但是如果使用不当，会发生严重并发症，最严重的并发症就是导管断裂。导管一旦断裂并进入体内，会随着血流转移到心腔或肺动脉，如果不能得到及时和有效的治疗，可能发生异物阻塞、房颤的风险，严重者会危及患者的生命安全。在2018年12月，我院一名患者接受了乳腺癌手术并接受了中心静脉置管治疗，但在术后出现了PICC导管断裂并游离到上下腔静脉以及右侧髂外静脉的不良情况，经积极治疗，没有给病人带来不良后果，现将该案影像诊断与临床治疗体会报告如下。

Abstract: The Technical Practice of Venous Therapy and Nursing issued by the National Health Commission clearly states that PICC is suitable for medium to long-term intravenous therapy and can be used for a variety of types of drug infusion. PICC catheterization technology has the advantages of simple and safe operation, avoiding multiple punctures, reducing the damage of chemotherapeutic drugs or hypertonic fluids to blood vessels, easy placement, high safety, and convenience for carrying. However, if used improperly, serious complications can occur, with the most severe being catheter breakage. If the catheter breaks and enters the body, it can be carried by the blood flow to the heart chamber or pulmonary artery. If timely and effective treatment is not received, there is a risk of foreign body embolism and atrial fibrillation, and in severe cases, it can endanger the patient’s life safety. In December 2018, a patient in our hospital received breast cancer surgery and received central venous catheterization. However, after the operation, there was an adverse condition in which the PICC catheter was broken and freed to the upper and lower vena cava and the right extrailiac vein. After active treatment, there was no adverse aftertreatment to the patient. The imaging diagnosis and clinical treatment experience of the case are reported as follows.