地塞米松溶液预处理外周静脉置入中心静脉导管预防早产儿静脉炎随机双盲对照试验  

The value of dexamethasone solution pretreatment PICC catheter in the prevention of premature infants phlebitis:a randomized double-blind trial

作　　者：罗春绸[1] 陈开珠[2] 杨李娜[3] 张淑芸[1] 陈少环 余小琴[1] 林娟斌 朱凌燕[1] 

机构地区：[1]福建医科大学附属漳州市医院儿科监护室,漳州363000 [2]福建医科大学附属漳州市医院护理部,漳州363000 [3]福建医科大学附属漳州市医院药学部,漳州363000

出　　处：《中国循证儿科杂志》2013年第5期352-355,共4页Chinese Journal of Evidence Based Pediatrics

摘　　要：目的探讨地塞米松溶液预处理导管在预防早产儿经外周静脉置入中心静脉导管(PICC)所致静脉炎中的可行性及安全性。方法 186例需行PICC置管术的低出生体重儿随机分为两组。两组均采用标准操作规范置入PICC,地塞米松组92例置管前使用地塞米松0.08 mg·mL-1稀释液50 mL浸泡PICC导管,生理盐水组94例使用生理盐水50 mL浸泡PICC导管,浸泡时间均为5 min。比较两组患儿置管术后静脉炎的发生率、出现时间、严重程度及其他导管相关并发症发生情况。结果地塞米松组静脉炎发生率14.1%(13/92),平均出现时间为(4.4±1.0)d,生理盐水组分别为33.0%(31/94)和(2.8±0.8)d,地塞米松组静脉炎严重程度低于生理盐水组,两组间差异均有统计学意义(P<0.05)。两组其他置管相关并发症发生率差异无统计学意义(P>0.05)。结论在早产儿PICC置管前,使用地塞米松溶液预处理导管,能降低PICC所致静脉炎发生率及其严重程度,且能延缓静脉炎出现时间,未增加其他导管相关并发症。Objective To investigate the feasibility and safety of dexamethasone solution pretreatment catheter in the prevention of phlebitis caused by PICC in premature infants. Methods 186 cases of low-birth-weight premature infants requiring PICC were randomly divided into two groups. Both groups were treated with standard operating procedure in PICC. 92 cases were in group A（intervention group）, PICC catheter was immersed using 0.08 mg ~ mL-~ dexamethasone aqua 50 mL before intubation. 94 cases were in the group B（ control group） , PICC catheter was immersed using physiological saline 50 mL. Catheter were treated for 5 rain for both groups. Two groups were compared in the incidence rate of phlebitis, time of occurrence, the severity of phlebitis and other complications except phlebitis. Results The incidence of phlebitis was 14. 1%, the average time of occmTence was （4.4 ± 1.0） days for intervention group, versus 33%, （2.8 ± 0.8 ） days in the control group. The intervention group had slighter phlebitis than the control group. All the above were statistically significantly different. The other catheter related complications were not statistically different between two groups. Conclusion The use of dexamethasone solution pretreatment catheter could reduce the frequency and severity of PICC-associated phlebitis, and could delay the occurrence time of phlebitis in low-birth-weight premature infants receiving PICC operations. The other catheter related complications were not increased.

关 键 词：地塞米松 经外周中心静脉置管术 静脉炎 早产儿 随机双盲对照试验 

分 类 号：R472[医药卫生—护理学]