低出生体质量儿PICC后并发机械性静脉炎影响因素的病例对照研究  

Case-control Research of Mechanical Phlebitis on Low Birth Weight Neonates with Peripherally Inserted Central Catheter

作　　者：李智英[1] 刘晓红[1] 司徒妙琼[1] 周芳静 

机构地区：[1]中山大学附属第一医院儿科,广东广州510080 [2]中山大学公共卫生学院,广东广州510089

出　　处：《护理学报》2015年第6期56-59,共4页Journal of Nursing（China）

基　　金：广东省医学科研指令性课题项目(C2011007)

摘　　要：目的探讨低出生体质量儿PICC后并发机械性静脉炎的相关因素,提出预防护理对策。方法选取2012年5月—2014年10月广州市某三级甲等医院新生儿科收治低出生体质量儿387例,PICC后发生机械性静脉炎40例患儿为病例组,未发生机械性静脉炎347例患儿为对照组,对影响其PICC后发生机械性静脉炎的相关因素进行多因素Logistic回归分析。结果多因素Logistic回归分析显示,出生体质量、穿刺次数及置管途径是低出生体质量儿PICC后并发机械性静脉炎的独立影响因素(P<0.05)。387例低出生体质量儿出现PICC置管后并发机械性静脉炎40例,发生率为11.5%(4.96/1 000导管日)。体质量是机械性静脉炎的保护因素(P<0.05);置管途径、穿刺次数是PICC后并发机械性静脉炎的危险因素(P<0.05),置管途径为腋静脉者发生机械性静脉炎的风险低于其他静脉(P<0.05)。结论低出生体质量儿在使用PICC时,选择合适的置管途径能有效减少PICC并发症的发生,低出生体质量儿PICC置管途径可优先选择腋静脉,提高穿刺技能,尽量减少穿刺次数,并密切观察有无并发症发生,应及时发现并处理,以降低PICC置管并发机械性静脉炎的风险。Objective To explore the related factors of mechanical phlebitis after PICC of low birth weight neonates and to provide the basis for clinical safe use of PICC. Methods A prospective study was conducted and from May 2012 to October 2014, 387 low birth weight neonates in one Class III Grade I hospital were included. Forty neonates with mechanical phlebitis after PICC were involved in experiment group and 347 without in control group. The data analysis was carried out with single factor analysis and multivariable logistic regression analysis. Results The influence factors of mechanical phlebitis after PICC included birth weight, puncture times and method of catheter （P〈;0.05）. Of the total, the incidence of mechanical phlebitis was 11.5% （4.96/1000 catheter）. Birth weight was the protective factor of mechanical phlebitis but puncture times and method of catheter were risk factors （ P〈;0.05）. Conclusion When PICC is applied for low birth weight neonates, the appropriate PICC approach can effectively reduce the occurrence of complications and axillary vein is a priority for low birth weight neonates ’ PICC indwelling; the improvement of the puncture skills, the reducing of puncture times and closely observation of any complications, especially the occurrence of mechanical phlebitis benefit reducing mechanical phlebitis after PICC.

关 键 词：低出生体质量儿 机械性静脉炎 

分 类 号：R472.9[医药卫生—护理学]