Abstract：Objective To explore the application effect of improved sheath delivery technology in peripherally inserted central catheter(PICC)placement under ultrasound B guidance in patients with thrombocytopenia.Methods From June 2019 to June 2020,a total of 81 patients with thrombocytopenia who underwent PICC catheterization under the guidance of B-ultrasound in the Department of Hematology of Shangrao People′s Hospital were selected as research subjects.According to the random number table,they were divided into a traditional group with 41 cases and a modified group with 40 cases.The modified group used a modified sheath delivery method to expand the skin,and the traditional group used a traditional scalpel to expand the skin.Catheterization conditions of the two groups including the success rate of one-time catheterization,completion time of delivery of the sheath,blood loss immediately after the expansion of the skin and delivery of the sheath,the score of pain immediately after catheterization and the post-intubation conditions were compared.In addition,including the number of dressing changes within 96 hours of catheter placement and the occurrence of complications.Results There was no statistically significant difference in the success rate of one-time catheterization between the two groups(P>0.05).The delivery time of the modified group was shorter than that of the traditional group,the difference was statistically significant(P<0.05).The blood loss immediately after the expansion and delivery of the sheath was less than that of the traditional group,the difference was statistically significant(P<0.05).The pain score was lower than that of the traditional group,and the differences were statistically significant(P<0.05).The number of dressing changes within 96 hours of catheter placement in the modified group was less than that of the traditional group,and the incidence of bleeding,exudation,and puncture point infections were lower than that of the traditional group,the difference was statistically significant(P<0.05).Conclusion In patients with thrombocytopenia,the successful rate of one-time catheterization for PICC under the guidance of B-ultrasound is equivalent to that of traditional scalpel expansion.The improved sheath delivery technology can shorten the delivery completion time,reduce the number of dressing changes after catheter placement and the blood loss immediately after expanding the sheath and deliver the sheath,and alleviate pain immediately after catheter placement in higher safety.
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