ECG定位导管尖端技术在新生儿经下肢静脉置入PICC中的应用  

Application of ECG positioning catheter tip technique in neonatal PICC placement through lower extremity vein

作　　者：徐兵[1] 杨丽娟[1] 戴明红[1] 郝佳丽 XU Bing;YANG Li-juan;DAI Ming-hong;HAO Jia-li(Department of Paediatrics,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院儿科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2022年第11期1591-1593,共3页Journal of Bengbu Medical College

摘　　要：目的:探讨腔内心电图(ECG)定位导管尖端技术在新生儿经外周置入中心静脉导管(peripherally inserted central catheters,PICC)中的应用及效果。方法:采用回顾性分析方法,将2014年1月至2017年12月经下肢静脉置入PICC的39例新生儿设为对照组,2018年1月至2020年12月经下肢外周静脉置入PICC的42例新生儿设为观察组。对照组置管成功后固定PICC导管,拍摄X线片;观察组将导管送至比预定长度长2 cm时,患儿穿刺侧肢体呈外展屈曲位,连接心电监护仪,推注0.9%氯化钠溶液,心电监护仪上出现P波与QRS波之比40%~50%,再缓慢外拔导管至P波与体表心电图的P波一致,固定PICC导管,拍摄X线片。根据X线片结果,观察2组一次置管到位率、完成治疗率。结果:观察组PICC导管一次置管到位率为95.23%(40/42),高于对照组的76.92%(30/39)(P<0.05);2组完成治疗率差异无统计学意义(P>0.05)。结论:ECG可用于辅助定位新生儿经下肢置入PICC导管尖端的位置,且操作简单,容易掌握,方法安全、可行,值得临床推广应用。Objective:To investigate the application and effect of ECG positioning catheter tip technique in peripherally inserted central catheters(PICC)placement through lower extremity vein in neonates.Methods:A retrospective analysis was performed to select 39 neonates with PICC from January 2014 to December 2017 as control group,and 42 neonates with PICC from January 2018 to December 2020 as observation group.In the control group,PICC catheter was fixed and chest X-ray was taken after successful catheterization.In the observation group,when the catheter was sent to 2 cm longer than the predetermined length,the limbs on the puncture side of the children were in abducting flexion,the ECG monitor was connected,and normal saline was injected.The ratio of P wave to QRS wave appeared on the ECG monitor was 40%-50%.Then the catheter was slowly pulled out until the P wave was consistent with the P wave of the body surface electrocardiogram.According to the X-ray results,the accuracy of one-time placement of PICC and the completion rate of treatment were observed in the two groups.Results:The accuracy of one-time placement of PICC in the observation group was 95.23%(40/42),which was higher than that of the control group(76.92%,30/39)(P<0.05).There was no significant difference in the treatment completion rate between the two groups(P>0.05).Conclusions:ECG can be used to assist the positioning of the tip of PICC catheter placement through the lower extremity vein in neonates,and the operation is simple,easy to master,safe and feasible,and worthy of clinical application.

关 键 词：经外周置入中心静脉导管 腔内心电图定位 新生儿 

分 类 号：R473.72[医药卫生—护理学]