早产儿经外周静脉穿刺中心静脉置管非计划性拔管的原因分析及护理对策  

The reasons for unplanned extubation of peripherally inserted central catheter in premature infants and related nursing management

作　　者：唐秀红[1] 盛晓郁[1] 张花[1] TANG Xiuhong;SHENG Xiaoyu;ZHANG Hua(Department of Neonatology, Children's Hospital of Soochow University, Suzhou, Jiangsu, 215000)

机构地区：[1]苏州大学附属儿童医院新生儿科,江苏苏州215000

出　　处：《中西医结合护理（中英文）》2020年第7期146-149,共4页Journal of Clinical Nursing in Practice

摘　　要：目的分析早产儿经外周静脉穿刺中心静脉置管(PICC)非计划性拔管的原因,并总结护理对策。方法回顾性分析2015年4月—2018年9月新生儿科NICU收治的191例早产儿的临床资料,统计非计划性拔管发生情况。结果191例PICC置管的早产儿中有34(17.80%)例发生非计划性拔管,导管平均留置时间为(26.88±14.99)d。非计划性拔管的主要原因分别为穿刺处渗血渗液(35.29%),患儿病情变化、血培养阳性(17.65%),肢体肿胀(14.71%),堵管后溶栓失败(11.76%)。结论探讨早产儿发生非计划性拔管的高危因素,有助于临床制定更细致的预防措施,以降低早产儿非计划性拔管的发生率。导致早产儿非计划性拔管的主要原因为穿刺处渗血渗液,应重视这类问题的处理。Objective To analyze the potential reasons for unplanned extubation of peripherally inserted central catheter(PICC)in premature infants,and summarized related nursing management.Methods A retrospective study of 191 premature infants was conducted to analyze the reasons for unplanned extubation of PICC.Results The unplanned extubation of PICC was identified in 34 cases,accounting for 17.80%.The average indwelling tine of PICC was(26.88±14.99)days.The main causes of unplanned extubation of PICC was blood seepage/exudation at puncture sites,changes in conditions or positive blood culture,limb edema,failed thrombolysis for tube blockage,accounting for 35.29%,17.65%,14.71%and 11.76%,respectively.Conclusion Risk Analysis of unplanned extubation could help to making more detailed measures for prevention of unplanned extubation of PICC in premature infants.More attention should be paid on high-risk factors such as blood seepage/exudation.

关 键 词：早产儿 经外周静脉穿刺中心静脉置管 非计划性拔管 预防 护理 

分 类 号：R473.72[医药卫生—护理学]