Application of ultrasound-guided modified Seldinger technique in patients with severe leukocytopenia and thrombocytopenia

Abstract

Objective To explore the effect of ultrasound-guided modified Seldinger technique for patients with severe leukocytopenia and thrombocytopenia, and to provide evidences for the selection of an appropriate PICC intubation method for these patients in clinical practice. Methods According to their vascular conditions, 83 hematologic malignancy patients with severe leukocytopenia and thrombocytopenia were divided into an experimental group (PICC intubation by using ultrasound-guided modified Seldinger technique; n=31) and a control group (conventional PICC intubation; n=52). The bleeding volume, number of puncture, indwelling time of catheter, and incidence of complications were compared between these two groups. Results The number of puncture and indwelling time of catheter of the experimental group were significantly better than those of the control group (both P 0.05). The incidence of complications of the experimental group was evidently lower than that of the control group, with a statistical difference (P<0.05). In the control group, misleading the catheter into artery occurred in 1 case, misleading the catheter into internal jugular vein occurred in 1 case, and cracking of some catheters in the body occurred in 2 cases; no severe complication occurred in the experimental group. Conclusion With the advantages of a high success rate of catheterization by one-time puncture, long indwelling time, a reduced cost, and a low incidence of complications and no severe complication, PICC intubation by using ultrasound-guided modified Seldinger technique should be the preferred PICC intubation method for hematologic malignancy patients with severe leukocytopenia and thrombocytopenia. Key words: Ultrasound-guided; Modified Seldinger technique; Severe leukocytopenia and thrombocytopenia; Patients; Application