骨髓输液在PICU的应用探讨  

Discussion for clinical application of bone marrow infusion in PICU

作　　者：骆翠媚[1] 彭婉仪[1] 郭小玲[1] 

机构地区：[1]中山市博爱医院儿科,528400

出　　处：《中国实用护理杂志》2004年第11期1-2,共2页Chinese Journal of Practical Nursing

基　　金：中山市卫生局立项课题 (编号 :2 0 0 2J2 14 )

摘　　要：目的　探讨骨髓输液在PICU的适应证、方法及临床效果。方法　选择PICU危重症建立静脉通道困难患儿 30例 ,采用 7号骨穿针或 7～ 9号头皮针于胫骨粗隆下 1～ 2cm穿刺、固定 ,接入医嘱液体 ,记录穿刺所需时间、入液速度及生命体征变化、并发症等。结果　 2 8例 1次成功 ,2例用头皮针者有堵塞 ,换针后重新穿刺成功 ,穿刺、固定到接入液体平均时间 (30± 10 )s。速率 :一般压力 (8± 3)ml (kg体重·h) ,加压下 (17± 6 )ml (kg体重·h) ,所有病例均达到了医嘱要求。骨髓输液持续时间 3～ 2 2h ,无 1例出现并发症。结论　骨髓输液在PICU危重症抢救中可迅速建立液体通道 ,争取抢救时间。头皮针比骨髓穿刺针易于固定 。Objective\ To explore the indications, method and clinical effect of bone marrow infusions in PICU. Method There were 30 cases serious children in the PICU who were difficult to set up vein infusion. It took No7 paracentetic needle of born marrow or No7～9 needle of scalp for puncture into 1～2 cm under tibial tuberosity and fix there, then infuse fluid by physician order and record the time of puncture, infusion velocity, life signs and complications. Result 28 cases success in the first time, 2 cases success in the second time because blockage of the needle of scalp. The average time of puncture, fixed and infused were (30±10) s. Infusion velocity : normal pressure were 8±3 ml/kg·h, added pressure were 17±6 ml/kg·h. All the cases can obey the physician order. The time of bone marrow infusions lasted 3～22 h. There were no complications in all cases. Conclusions Bone marrow infusions in PICU can set up fluid infusion path for emergency treatment of serious cases more quickly. It can save time for rescues. It's good for use the needle of scalp because it is easier for fixing then the paracentetic needle of born marrow and uses more expediently.

关 键 词：输液 骨髓 并发症 穿刺 头皮针 PICU 危重症 医嘱 固定 抢救 

分 类 号：R472[医药卫生—护理学] R683[医药卫生—临床医学]