极/超低出生体质量儿经外周静脉置入中心静脉导管相关并发症及影响因素分析  

Analysis of PICC-Related Complications and Related Factors in Very Extremely Low Birth Weight Infants

作　　者：李蕊[1] 王晶[1] 王佳琦[1] 王丽娟[1] 陈华[2] LI Rui;WANG Jing;WANG Jiaqi;WANG Lijuan;CH EN Hua(Department of Pediatrics,Peking University Third Hospital,Beijing 100191,China;Department of Gynecology and Pediatrics,School of Nursing,Peking University,Beijing 100191,China)

机构地区：[1]北京大学第三医院儿科,北京100191 [2]北京大学护理学院妇儿教研室,北京100191

出　　处：《解放军护理杂志》2020年第4期51-54,共4页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的调查极/超低出生体质量儿经外周静脉置入中心静脉导管(peripherally inserted central venous catheters,PICC)相关并发症的发生情况,探讨PICC相关并发症的影响因素。方法便利抽样法选取北京市某三级甲等综合医院新生儿重症监护病房收治的极低和超低出生体质量儿为研究对象,分析其PICC相关并发症的发生情况及影响因素。结果本研究共纳人360例极低和超低出生体质量儿,其中有49例极/超低出生体质量儿发生PICC相关并发症,发生率为13.6%。Logistic回归分析显示,胎龄<30周的早产儿发生PICC导管相关并发症的风险是胎龄≥30周的2.39倍;正中静脉/头静脉、大隐静脉/颞浅静脉置管发生并发症的风险分别是腋静脉置管的12.32倍和9.85倍。结论极低或超低出生体质量儿推荐考虑腋静脉和贵要静脉作为PICC置管的穿刺静脉;在导管维护过程中应保证及时有效的指标监测,以降低导管相关并发症的发生风险。Objective To investigate the incidence of PICC related complications in very extremely low-birth weight infants and explore the related factors affecting PICC related complications.Methods By con venience sampling method,the cases of very/extremely low birth weight infants who needed PICC in NICU of the hospital from June 2016 to September 2018 were selected and investigated for the incidence and influencing factors of PICC related complications.Results Among 360 cases.49 cases of very/extremely low-birth weight infants had PICC-related complications.the incidence rate was 13.6%.Logistic regression analysis showed that the risk of PICC catheter related complications in preterm infants with gestational age less than 30 weeks was 2.39 times higher than that in infants with gestational age more than 30 weeks:the risk of complications in median/cephalic vein catheterization was 12.32 times higher than that in axillary vein catheterization;and the risk of complications in great saphenous superficial temporal vein catheterization was 9.85 times higher than that in axillary vein catheterization.Conclusions Hick and straight veins are better for very/extremely low birth weight infants.so axillary veins and basilic veins are recommended as the preferred veins for PICC catheterization.In order to reduce the risk of catheter-related complications,timely and effective monitoring of indicators should be ensured during catheter maintenance.

关 键 词：极/超低出生体质量儿 经外周静脉置入中心静脉导管 相关并发症 

分 类 号：R472.72[医药卫生—护理学]