生理盐水引导腔内心电图技术用于早产儿脐静脉置管尖端定位的效果  

Effect of Saline Guided Intracavitary Electrogram on Tip Localization of Umbilical Vein Catheterization in Premature Infants

作　　者：江雪玲 廖瑞雪 JIANG Xueling;LIAO Ruixue(Three Gorges Hospital Affiliated to Chongqing University,Chongqing 404000,China)

机构地区：[1]重庆大学附属三峡医院,重庆404000

出　　处：《中国医药指南》2022年第22期13-16,共4页Guide of China Medicine

基　　金：重庆市万州区科卫联合医学科研项目(wzstc-kw2020037)。

摘　　要：目的探讨生理盐水引导腔内心电图技术用于早产儿脐静脉置管尖端定位的临床效果。方法选取2020年11月至2021年3月医院新生儿科实施脐静脉置管的120例早产儿,按住院号尾数的奇偶数分为干预组与对照组,每组60例。对照组采用传统方法置管后,行床旁胸腹部X线摄片确定导管尖端的具体位置,干预组利用生理盐水引导腔内心电图技术定位脐静脉置管后导管的尖端位置。比较两组导管末端下腔静脉一次到位率、置管成功率、并发症的发生率、因导管置入过深或异位而需调整导管位置和需要复查X线片的早产儿比例,观察两组患儿的疼痛程度、送管困难率,统计两组的置管时间与穿刺处出血量。结果干预组导管尖端位置精准率、下腔静脉1次到位率高于对照组,而尖端位置过深率、异位率低于对照组(P<0.05)。在并发症发生率上,干预组低于对照组(P<0.05)。干预组穿刺5 min后NIPS评分及送管困难率低于对照组(P<0.05)。干预组置管时间短于对照组,穿刺处出血量少于对照组(P<0.05)。结论在早产儿实施脐静脉置管时,利用生理盐水引导腔内心电图技术定位导管尖端的准确率极高,能够在置管过程中精准调节导管置入深度,减轻早产儿的疼痛程度,降低送管困难率,缩短置管时间,减少穿刺处出血量。Objective To investigate the clinical effect of normal saline guided intracavitary electrogram(ECG)on the tip location of umbilical vein catheterization in preterm infants.Methods A total of 120 premature infants who underwent umbilical vein catheterization in neonatal pediatrics from December 2020 to December 2021 were divided into intervention group and control group,with 60 cases in each group.After the traditional method was used for catheter placement,the control group underwent bedside chest and abdomen X-rays to determine the specific position of the catheter tip,while the intervention group used saline-guided intracavitary electrocardiography to locate the catheter tip position after umbilical vein catheterization.The rate of onetime placement of the inferior vena cava at the end of the catheter,the success rate of catheter placement,the incidence of complications,the need to adjust the position of the catheter due to too deep or ectopic catheter placement,and the proportion of premature infants who need to review X-ray films were compared between the two groups.The pain degree and difficulty rate of catheter delivery in the two groups were compared,and the catheterization time and blood loss at the puncture site were calculated.Results The accuracy of catheter tip position and inferior vena cava once in place rate in the intervention group were higher than that in the control group,while the rate of too deep tip position,ectopic rate were lower than that in the control group(P<0.05).The incidence of complications in the intervention group was lower than that in the control group(P<0.05).The intervention group was lower than the control group in terms of NIPS score 5 minutes after puncture and difficulty rate of tube delivery(P<0.05).The time of intubation in the intervention group was shorter than that in the control group;the bleeding volume at the puncture site was shorter in the intervention group than in the control group(P<0.05).Conclusion When umbilical vein catheterization is performed in prematur

关 键 词：早产儿 脐静脉 尖端定位 腔内心电图 

分 类 号：R722.6[医药卫生—儿科]