超声引导与X线定位导管尖端在早产儿脐静脉置管中的应用  

Application of ultrasound guidance and X-ray catheter tip positioning in umbilical vein catheterization in premature infants

作　　者：覃广萍 陈玲[2] 陈秋萍[1] QIN Guangping;CHEN Ling;CHEN Qiuping(Department of Neonatology,Pingxiang City People's Hospital,Jiangxi Province,Pingxiang 337000,China;Department of Imaging,Pingxiang People's Hospital,Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院新生儿科,江西萍乡337000 [2]江西省萍乡市人民医院影像科,江西萍乡337000

出　　处：《中国当代医药》2022年第32期113-115,119,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202140514)。

摘　　要：目的探讨超声引导与X线定位导管尖端在早产儿脐静脉置管(UVC)中的应用效果。方法回顾性分析2019年6月至2021年12月萍乡市人民医院收治的42例符合UVC指征的早产儿临床资料,根据置管不同检查方式分为X线组(n=20)与超声组(n=22)。X线组UVC后采用X线定位调整导管尖端,超声组采用超声实时定位引导UVC,比较两组的置管效果(一次性穿刺成功率、置管操作时间、置管留置时间)、创伤后炎症反应程度[C反应蛋白(CRP)、降钙素原(PCT)、血小板计数(PLT)]、并发症总发生率(导管阻塞、导管移位、局部出血、渗液、感染、心律失常)。结果超声组患者的一次性穿刺成功率高于X线组患者,差异有统计学意义(P<0.05);超声组患者的置管操作时间短于X线组,置管留置时间长于X线组,差异有统计学意义(P<0.05)。置管前,两组的血清CRP、PCT、PLT水平比较,差异无统计学意义(P>0.05);置管后,超声组患者的血清CRP、PCT水平低于X线组,PLT水平高于X线组患者,差异有统计学意义(P<0.05);超声组患者的并发症总发生率低于X线组患者,差异有统计学意义(P<0.05)。结论超声引导下的UVC相较于X线定位导管尖端可有效提高一次性穿刺成功率,缩短置管操作时间,延长置管留置时间,降低创伤后炎性反应程度以及并发症发生风险。Objective To explore the application effect of ultrasound guidance and X-ray positioning catheter tip in umbilical vein catheterization(UVC)in premature infants.Methods The clinical data of 42 premature infants with UVC indications admitted to Pingxiang City People's Hospital from June 2019 to December 2021 were retrospectively analyzed.According to different examination methods of catheter placement,they were divided into the X-ray group(n=20)and the ultrasound group group(n=22).The X-ray group adopted the method of adjusting the catheter tip by X-ray positioning after UVC,and the ultrasound group adopted the method of real-time ultrasound positioning to guide UVC.The catheter placement effects(one-time puncture success rate,catheter placement operation time,and catheter placement time),the degree of post-traumatic inflammation([C-reactive protein,CRP],[procalcitonin,PCT],[platelet,PLT]),the total incidence of complications(catheter obstruction,catheter displacement,local bleeding,exudation,infection,arrhythmia)were compared between the two groups.Results The one-time puncture success rate in the ultrasound group was higher than that in the X-ray group,and the difference was statistically significant(P<0.05).The catheter placement operation time in the ultrasound group was shorter than that in the X-ray group,the catheter placement time in the ultrasound group was longer than that in the X-ray group,with statistical significance(P<0.05).Before catheterization,there were no significant differences in the levels of serum CRP,PCT and PLT between the two groups(P>0.05).After catheterization,the levels of serum CRP and PCT in the ultrasound group were lower than those in the X-ray group,while PLT level in the ultrasound group was higher than those in the X-ray group,the differences were statistically significant(P<0.05).The total incidence of complications in the ultrasound group was lower than that in the X-ray group,and the difference was statistically significant(P<0.05).Conclusion Compared with X-ray catheter tip

关 键 词：脐静脉置管 超声引导 X线定位 早产儿 应用效果 

分 类 号：R722.6[医药卫生—儿科]