实时超声检查在新生儿PICC尖端定位中的应用研究  

The application study of real-time ultrasound in PICC tip location for newborns

作　　者：赵宁[1] 张晓曼 李高阳 张瑞[3] 贺新建[1] ZHAO Ning;ZHANG Xiaoman;LI Gaoyang;ZHANG Rui;HE Xinjian(Department of Ultrasound,Hebei Children's Hospital,Shijiazhuang 050031,China;Department of Newborn,Hebei Children's Hospital,Shijiazhuang 050031,China;Clinical Laboratory,The Secod Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北省儿童医院超声诊断科,河北石家庄050031 [2]河北省儿童医院新生儿科,河北石家庄050031 [3]河北医科大学第二医院检验科,河北石家庄050000

出　　处：《医学影像学杂志》2022年第10期1781-1785,共5页Journal of Medical Imaging

基　　金：河北省卫健委医学科学研究重点课题项目(编号:20170405)。

摘　　要：目的 探讨实时超声检查在引导新生儿经外周静脉置入中心静脉导管(peripherally inserted central venous catheters,PICC)尖端定位的临床应用价值。方法 选取我院行PICC置管术新生儿分为对照组和实验组。对照组90例,行常规PICC置管术,实验组85例,采用实时超声引导PICC置管全程,两组患儿术后均行X线摄影评估导管尖端定位准确性。如首次尖端定位不理想需进行二次调整,且再次评估尖端定位准确性,直至定位理想。观察两组患儿PICC尖端定位准确率、术后并发症情况,比较首次和二次置管术后并发症发生率的差异。结果 实验组首次PICC尖端定位准确率明显高于对照组(P <0.05),PICC尖端位置过深发生率明显低于对照组(P <0.05),PICC置管术后并发症发生率也明显低于对照组(P <0.05);对照组二次PICC置管术后并发症发生率明显高于首次置管(P <0.05)。结论 实时超声引导PICC置管术全过程可明显提高尖端定位准确率,降低新生儿术后并发症的发生率。Objective To explore the clinical application value of real-time ultrasound in guiding the tip location of peripherally inserted central venous catheters PICC for newborns.Methods Newborns underwent PICC puncture in our hospital were divided into control group and experimental group.90 newborns of control group underwent traditional PICC catheterization,real-time ultrasound was used in guiding the whole process of PICC tip location for 85 newborns of experimental group,X-ray radiography was taken to evaluate the accuracy of catheter tip location after puncture for two groups of newborns.If the first catheter tip location was not ideal,the second adjustment should be made,and reevaluated the accuracy of tip location,until the location was ideal.The accuracy of PICC tip location and postoperative complications of two groups of newborns were observed.The difference of the postoperative complications incidence between the first and second catheterization was compared.Results The accuracy rate of the first PICC tip location in experimental group was significantly higher than that of control group(P<0.05).The incidence of excessive deep PICC tip location was significantly lower than that of control group(P<0.05).The incidence of PICC postoperative complications was also significantly lower than that of control group(P<0.05);In control group,the incidence of the second PICC postoperative complications was significantly higher than the first time.Conclusion Real time ultrasound-guided the whole process of PICC catheterization can significantly improve the accuracy rate of tip location,and reduce the incidence of postoperative complications of newborns.

关 键 词：实时超声检查 外周静脉置入中心静脉导管 X线摄影 导管尖端定位 新生儿 

分 类 号：R472[医药卫生—护理学] R445.1[医药卫生—临床医学] R814.3