经PICC监测中心静脉压的范围综述

doi:10.3761/j.issn.2096-7446.2025.09.020

摘要/Abstract

摘要：

目的分析经外周静脉穿刺的中心静脉导管（peripherally inserted central catheter，PICC）用于监测中心静脉压（central venous pressure，CVP）的相关研究，明确经PICC监测CVP的可行性、准确性，材料选择，测量方法及注意事项等，为临床实践提供参考。方法计算机检索PubMed、Cochrane Library、Web of Science、MEDLINE、中国知网、维普数据库以及万方数据知识服务平台从建库至2024年8月31日发表的关于PICC监测CVP的文献并进行归纳总结。结果共纳入21篇文献，其中19篇为随机对照试验研究，2篇为Meta分析，多数研究比较了经PICC和经中心静脉导管（central venous catheter，CVC）测量的CVP结果，两者存在高度一致性。PICC测量CVP的主要影响因素包括胸腔压力变化、管道通畅程度、管道固有阻力、导管尖端位置、导管前端开口类型等。结论 PICC测量的CVP值与CVC的测量值具有一致性，在患者需要监测CVP指导治疗，但因时间因素或患者自身原因无法进行CVC置管时，可以使用PICC进行CVP的测量，但在测量过程中应注意导管的选择及规避引起测量误差的影响因素。

关键词: PICC, 中心静脉压, 监测, 范围综述, 循证护理学

Abstract:

Objective To analyze relevant studies on the use of peripherally inserted central catheters（PICC） for monitoring central venous pressure（CVP），and to clarify the feasibility，accuracy，material selection，measurement methods，and precautions for monitoring CVP via PICC，providing reference for clinical practice. Methods A computer search was conducted across PubMed，Cochrane Library，Web of Science，MEDLINE，CNKI，VIP，and Wanfang Data for literature published from the inception of the databases until 2024，regarding PICC for CVP monitoring. The selected articles were summarized. Results A total of 21 studies were included，of which 19 were randomized controlled trials（RCTs） and 2 were meta-analyses. Most studies compared CVP results measured through PICC and through central venous catheter（CVC），and there was high consistency between the two. The main factors influencing the measurement of CVP by PICC included the change of thoracic pressure，patency of catheter，the inherent resistance of catheter，the position of catheter tip，and the type of catheter front opening. Conclusion The CVP values measured via PICC are consistent with those measured using CVC. PICC can be used to measure CVP when CVC placement is not feasible due to time constraints or patient-related reasons. However，attention should be given to catheter selection and the avoidance of factors that could lead to measurement errors during the process.

Key words: PICC, Central Venous Pressure, Monitor, Scoping Review, Evidence-Based Nursing

许欣, 王紫馨, 王巍, 封秀琴. 经PICC监测中心静脉压的范围综述[J]. 中华急危重症护理杂志, 2025, 6(9): 1138-1143.

XU Xin, WANG Zixin, WANG Wei, FENG Xiuqin. A scoping review of central venous pressure monitored via peripherally inserted central catheters[J]. Chinese Journal of Emergency and Critical Care Nursing, 2025, 6(9): 1138-1143.

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