公式法和测量法预估新生儿脐静脉置管长度的效果评价  

Evaluation of the accuracy of revised Shukla-Ferrara formula and Dunn method in determination of umbilical venous catheter insertion length in neonates

作　　者：陈丽莲 穆晓和 熊小云 杨传忠 刘杰 CHEN Lilian;MU Xiaohe;XIONG Xiaoyun;YANG Chuanzhong;LIU Jie(Department of Neonatology,Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University,Shenzhen,Guangdong 518028,China;School of Nursing,Shanxi University of Chinese Medicine,Jinzhong,Shanxi 030600,China)

机构地区：[1]南方医科大学附属深圳妇幼保健院新生儿科,广东深圳518028 [2]山西中医药大学护理学院,山西晋中030600

出　　处：《重庆医学》2022年第4期630-633,639,共5页Chongqing medicine

基　　金：广东省深圳市“医疗卫生三名工程”资助项目(SZSM201612045);广东省高水平临床重点专科(SZGSP009);深圳市妇幼保健院院内科研基金项目(FYB2018006)。

摘　　要：目的评价改良Shukla-Ferrara公式法和Dunn测量法预估新生儿脐静脉置管长度的效果。方法将2019年1月至2020年8月在南方医科大学附属深圳妇幼保健院新生儿重症监护室行脐静脉置管术的400例新生儿,采用随机数字表法分为公式组和测量组,各200例,分别采用改良Shukla-Ferrara公式法和Dunn测量法预估脐静脉置管长度,比较两组患儿预估置管深度、脐静脉置管成功率,以及最佳位置、位置过高、位置过低的置管百分比,并将置管成功患儿以出生体重小于1500 g和出生体重大于或等于1500 g进行亚组分析。结果公式组与测量组脐静脉置管成功率比较,差异无统计学意义(63.5%vs.62.5%,χ^(2)=0.042,P=0.838)。脐静脉置管成功患儿中,公式组置管最佳位置百分比高于测量组,差异有统计学意义(52.8%vs.34.2%,P<0.05);测量组预估置管深度和置管位置过高百分比均高于公式组,差异有统计学意义(P<0.05);两组置管位置过低百分比无明显差异(P>0.05)。出生体重小于1500 g的患儿,公式组置管最佳位置百分比明显高于测量组(50.5%vs.33.0%,P<0.05);出生体重大于或等于1500 g的患儿,两组置管最佳位置百分比无明显差异(P>0.05)。结论公式法预估脐静脉置管长度的效果优于测量法,尤其适用于出生体重小于1500 g的新生儿。Objective To evaluate the accuracy of the revised Shukla-Ferrara formula and Dunn method to determine the umbilical venous catheters insertion length in neonates.Methods From January 2019 to August 2020,a total of 400 neonates who received umbilical venous catheterization(UVC)in Affiliated Shenzhen Maternity&Child Healthcare Hospital were selected and randomly divided into the formula group and the measurement group,with 200 cases in each group.The revised Shukla-Ferrara formula and Dunn method were used to determine the umbilical venous catheters insertion length,respectively.The estimated depth of intubation,the success rate of UVC,and the rate of optimal position,high position and low position were compared between the two groups.Subgroup analysis was performed on neonates successfully catheterized with birth weight<1500 g and≥1500 g.Results There was no significant difference in the success rate of UVC between the formula group and the measurement group(63.5%vs.62.5%,χ2=0.042,P=0.838).Among the neonates successfully catheterized,the percentage of optimal position for insertion in the formula group was higher than that in the measurement group,and the difference was statistically significant(52.8%vs.34.2%,P<0.05).The percentage of high position for insertion and estimated depth of intubation in the measurement group were higher than those in the formula group,and there were statistically significant differences(P<0.05).There was no significant difference in the percentage of low position for insertion between the two groups(P>0.05).For neonates with birth weight<1500 g,the percentage of optimal position for insertion in the formula group was significantly higher than that in the measurement group(50.5%vs.33.0%,P<0.05).For neonates with birth weight≥1500 g,there was no significant difference in the percentage of optimal position for insertion(P>0.05).Conclusion The estimated depth of umbilical venous catheters determined by the revised Shukla-Ferrara formula method is better than by the Dunn method,especia

关 键 词：新生儿 脐静脉导管 Dunn测量法 改良Shukla-Ferrara公式法 置管长度 

分 类 号：R722.1[医药卫生—儿科]