极低/超低出生体重儿上肢和下肢静脉留置PICC的对照观察  

A comparative observation of venous indwelling PICC in the upper and lower extremities of very low/extremely low birth weight neonates

作　　者：印玉静 马月兰[1] 刘小玲[1] YIN Yujing;MA Yuelan;LIU Xiaoling(Suzhou Municipal Hospital,Suzhou,215002,China)

机构地区：[1]江苏省苏州市立医院本部新生儿监护室,215002

出　　处：《护理实践与研究》2022年第12期1842-1845,共4页Nursing Practice and Research

基　　金：苏州市“科教兴卫”青年科技项目(编号:KJXW2019026)。

摘　　要：目的观察在极低/超低出生体重儿中经下肢和上肢不同静脉途径留置PICC导管的置管效果和并发症的发生情况,以确定最佳留置导管部位。方法回顾性分析2020年1—12月医院201例极低/超低出生体重儿经上、下肢不同静脉途径留置PICC导管。将上肢静脉置管者155例作为对照组,将下肢静脉置管者46例作为观察组。比较两组一次穿刺成功率、一次送管成功率、置管所需时间、止血时间、留置时间等置管效果指标,以及导管堵塞、导管异位、局部渗液、静脉炎和怀疑或明确感染等并发症的发生情况。结果观察组置管一次穿刺成功率和一次送管成功率高于对照组,组间比较差异具有统计学意义(P<0.05);两组置管所需时间、止血时间、留置时间组间比较差异均无统计学意义(P>0.05);两组并发症发生情况比较差异无统计学意义(P>0.05)。结论经下肢静脉置管较上肢静脉置管在置管过程中操作简化,且不增加并发症的发生,可在综合考虑患儿的健康和血管各项因素之后,将经下肢静脉留置PICC作为极低和超低出生体重儿的首选置管方式。Objective To observe the effects of indwelling PICC catheters and the incidence of complications in very low/extremely low birth weight neonates through different venous routes of lower and upper extremities to determine the best indwelling catheter site.Methods A total of 201 cases of very low/extremely low birth weight neonates with indwelling PICC catheters in the upper and lower limbs were retrospectively analyzed from January to December 2020.A total of 155 patients with upper extremity venous catheters were selected as a control group,and 46 patients with lower extremity venous catheters were selected as an observation group.The indicators of catheterization effect,such as the success rate of one-time puncture,the success rate of one-time catheter delivery,the time required for catheterization,hemostasis time,indwelling time and other,and the occurrence of complications,such as catheter blockage,catheter ectopic,local exudation,phlebitis,and suspected or definite infection were compared between the two groups.Results The success rate of one-time puncture and one-time catheter delivery in the observation group were higher than those in the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the time required for catheterization,hemostasis time and indwelling time between the two groups(P>0.05).There was no significant difference in occurrence of complications between the two groups(P>0.05).Conclusion Compared with the upper extremity venous catheterization,the operation of the lower extremity venous catheterization was simpler and did not increase the occurrence of complications.After comprehensively considering the health of the child and various vascular factors,the indwelling PICC through the lower extremity vein was the preferred catheterization method for very low and extremely low birth weight neonates.

关 键 词：极低出生体重儿 超低出生体重儿 经外周中心静脉置管 置管效果 并发症 

分 类 号：R473.72[医药卫生—护理学]