经股静脉中段留置PICC在婴幼儿困难静脉通路的应用  

PICC placement via middle segment of femoral vein in infants and toddlers with difficult venous access(DIVA)

作　　者：陈珺 管萍[1] 何梦雪 杜袁英 Chen Jun;Guan Ping;He Mengxue;Du Yuanying(Department of Hematology,Shanghai Children′s Medical Center Affiliated to Medical College of Jiaotong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心血液肿瘤科

出　　处：《护理学杂志》2019年第15期9-13,共5页Journal of Nursing Science

摘　　要：目的探讨经股静脉中段留置PICC在婴幼儿困难静脉通路(DIVA)的应用效果。方法对困难静脉通路患儿102例采取经股静脉中段留置PICC,统计置管情况、置管及留置期间并发症。结果入组患儿均置管成功,导管留置时间8~307d;达到导管头端最佳位置率85.29%;置管过程中未发生误穿动脉,发生擦伤动脉2例(1.96%);导管原发异位发生率5.88%;留置期间并发症发生率23.53%,完成治疗正常拔管率87.25%(89例),意外拔管率12.75%(13例)。结论经股静脉中段留置PICC具有可行性,可有效解决婴幼儿困难静脉通路的中长期静脉治疗问题。Objective To investigate the effects of PICC insertion via middle segment of femoral vein in infants and toddlers with difficult venous access(DIVA).Methods Totally,102 DIVA infants and toddlers received PICC insertion via middle segment of femoral vein.The clinical data involving insertion,and complications associated with catheter placement and indwelling were summarized and analyzed.Results The success rate of catheterization was 100%.The indwelling time ranged from 8 to 307 days.The rate of catheter tip reaching the optimal position was 85.29%.There was no perforation of artery during insertion,though the needle grazing the artery did occur in 2 cases(1.96%).The incidence rate of primary malposition was 5.88%,and the incidence rate of complications during PICC indwelling was 23.53%.Eighty-nine children(87.25%)received PICC removal as planed after completion of the treatment,while thirteen children(12.75%)experienced unplanned removal.Conclusion The technique of PICC insertion via middle segment of femoral vein in DIVA infants and toddlers has high success rate.It can meet the mid-and long-term infusion need of DIVA infants and toddlers.

关 键 词：PICC 股静脉中段 困难静脉通路 静脉置管 静脉治疗 婴幼儿 

分 类 号：R473.72[医药卫生—护理学]