下肢PICC置管术在新生儿中置管效果及对舒适度的影响观察  

Effect of lower extremity PICC catheterization in neonates and its effect on the degree of comfort

作　　者：陈赢赢[1] 张静[1] 章优[1] 陈晓春[1] CHEN Yingying;ZHANG Jing;ZHANG You;CHEN Xiaochun(Department of Neonates, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Chin)

机构地区：[1]温州医科大学附属第二医院新生儿科,浙江温州325000

出　　处：《中国现代医生》2017年第30期57-60,共4页China Modern Doctor

基　　金：浙江省温州市2014年第一期科技计划项目(Y20140182)

摘　　要：目的探讨新生儿采用下肢PICC置管术的应用效果及对其舒适度的影响研究,为新生儿寻求最佳静脉置管路径提供依据。方法分析2014年2月~2016年11月期间于我院收治的新生儿112例,随机平均分为两组,其中对照组的56例新生儿采取上肢静脉穿刺置管,研究组的56例新生儿采取下肢静脉穿刺置管。对比两组的一次穿刺成功率、穿刺时间、出血量、留置时间、导管异位发生情况以及置管后的并发症,同时根据穿刺时和穿刺后疼痛评估量表NIPS评分结果及新生儿的心率情况进行舒适度比较。结果研究组新生儿的一次穿刺成功率、留置时间较对照组新生儿有明显优势(P均<0.05);研究组新生儿的穿刺时间、出血量、导管异位发生情况与对照组均存在明显差异(P<0.05);研究组穿刺时的NIPS疼痛评分明显低于对照组,在穿刺后1~5 min的评分也均低于对照组(P均<0.05);研究组新生儿穿刺时及穿刺后5 min的平均心率明显低于对照组(P均<0.05)。结论新生儿采用下肢静脉PICC置管术,具有安全可靠的置管效果,在穿刺时和穿刺后对新生儿的疼痛刺激较低,减轻对其舒适度的负面影响,推荐临床应用。Objective To explore the application effect of lower extremity PICC catheterization in neonates and its effect on the degree of comfort, and to provide the basis for newborns to find the best venous catheter path. Methods 112 neonates admitted in our hospital from February 2014 to November 2016 were analyzed and randomly divided into two groups. The control group（n=56） was treated with upper extremity venous catheterization, and the study group（n=56） was treated with lower extremity venous catheterization. The one-time success rate of puncture, puncture time, bleeding volume, retention time, catheter ectopic occurrence and complications after catheterization were compared between the two groups. The degree of comfort was compared according to the pain assessment scale NIPS score and neonatal heart rate when puncture and after puncture. Results The one-time success rate of puncture, retention time in the study group were significantly higher than those in the control group（P〈0.05）. There were significant differences in the puncture time, bleeding volume and catheter ectopic occurrence of neonates between the study group and the control group（P〈0.05）. The NIPS pain score in the study group was significantly lower than that in the control group when puncture. The score of the study group was also lower than that in the control group at 1-5 minutes after the puncture （P〈0.05）. The average heart rate in the study group was significantly lower than that in the control group when puncture and at 5 minutes after puncture（P〈0.05）. Conclusion tower extremity venous PICC catheterization has safe and reliable catheter effect in nenoates, which has low pain stimuli for newborns when puncture and after puncture, and can reduce the negative impact of the comfort degree in neonates, and is recommended in clinical application.

关 键 词：新生儿 下肢PICC置管术 置管效果 舒适度 

分 类 号：R472[医药卫生—护理学]