ISSN 2097-6046（网络）
ISSN 2096-7446（印刷）
CN 10-1655/R
主管：中国科学技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (8): 976-978.doi: 10.3761/j.issn.2096-7446.2026.08.014

• 重症护理研究 • 上一篇    下一篇

右上肢PICC置管患者孤立性永存左上腔静脉的识别及风险管理

胥喆1(), 徐红霞1, 封凤1, 谢睿1, 王飞霞2,*()   

  1. 1 浙江大学医学院附属第一医院静脉治疗护理门诊 杭州市 310003
    2 浙江大学医学院附属第一医院伤口、造口专科护士门诊部 杭州市 310003
  • 收稿日期:2025-08-23 出版日期:2026-08-10 发布日期:2026-08-04
  • 通讯作者: *王飞霞，E-mail：1299038@zju.edu.cn
  • 作者简介:胥喆：女，硕士，主管护师，E-mail：206485@zju.edu.cn
    作者贡献声明

    胥喆：论文撰写、研究实施；徐红霞：研究资料收集；封凤：研究资料收集；谢睿：研究实施；王飞霞：研究指导、论文修改

  • 基金资助:
    浙江省医药卫生科技计划项目(2022KY771)

Nursing experience of PICC catheterization in the right upper limb of a patient with isolated persistent left superior vena cava

XU Zhe1(), XU Hongxia1, FENG Feng1, XIE Rui1, WANG Feixia2,*()   

  1. 1 Vascular Access Nurse Specialist Clinic， the First Affiliated Hospital Zhejiang University School of Medicine， Hangzhou 310003
    2 Wound & Ostomy Nurse Specialist Clinic， the First Affiliated Hospital Zhejiang University School of Medicine， Hangzhou 310003
  • Received:2025-08-23 Online:2026-08-10 Published:2026-08-04
  • Contact: *WANG Feixia，E-mail：1299038@edu.zju.cn
  • Supported by:
    Zhejiang Provincial Medical and Health Science and Technology Program Project(2022KY771)

RichHTML

PDF下载

摘要：

总结1例右上肢PICC置管过程中对孤立性永存左上腔静脉的识别与护理体会。本病例患者置管前未知血管解剖异常，置管过程中心腔内电图定位未出现典型P波变化。通过鉴别PICC原发性异位、调试心电监护、协助患者肢体与体位配合、识别特殊心电图表现等，成功判断患者为孤立性永存左上腔静脉。置管后多学科讨论该患者留置PICC的可行性与安全性，最终患者保留PICC，顺利完成静脉输液治疗。

关键词: 中心静脉导管, 心电描记术, 永存左上腔静脉, 危重病护理

Abstract:

To summarize the identification and nursing experience of isolated persistent left superior vena cava（PLSVC） during PICC insertion in the right upper limb. The patient had no known vascular anatomical abnormalities before catheterization and no typical P-wave changes during intracardiac electrogram localization for PICC insertion. Isolated PLSVC was successfully diagnosed by identifying initial PICC malposition，adjusting ECG monitoring，assisting the patient with limb and body position coordination，and recognizing special ECG manifestations. After catheterization，a multidisciplinary discussion was held on the feasibility and safety of retaining the PICC. Finally，the patient retained the catheter，successfully completed intravenous infusion therapy，and was discharged.

Key words: Central Venous Catheters, Electrocardiography, Persistent Left Superior Vena Cava, Critical Care Nursing