无肝素化在新生儿PICC中的应用效果研究  

Effectofnon-heparinizedPICCinneonates

作　　者：郭舒文 张月葵 戴冬凰 张秀虹 林娟斌 Guo Shuwen;Zhang Yuekui;Dai Donghuang(The Zhangzhou Hospital,Zhangzhou,Fujian 363000)

机构地区：[1]漳州市医院,福建漳州363000

出　　处：《基层医学论坛》2022年第36期13-16,共4页The Medical Forum

摘　　要：目的探讨无肝素化在新生儿经外周穿刺中心静置管(PICC)中的应用效果。方法采用抽签法将723例入住NICU留置PICC导管的新生儿随机分为试验组402例和对照组321例,对照组每日更换大液体时用20mL注射器抽取生理盐水2~3mL脉冲式冲洗PICC导管后,再用20mL注射器抽取1~2mL淡肝素液(1U/mL)脉冲式冲洗导管,并将淡肝素[10U/(kgmL)]加入大液体持续泵入;试验组每日更换大液体时只用20mL注射器抽取生理盐水3~5mL脉冲式冲洗PICC导管。比较2组患儿导管留置时间及置管后堵管、静脉炎、感染等并发症发生率,白细胞、血小板计数及凝血功能。结果2组患儿导管留置时间及置管后并发症发生率差异无统计学意义(P>0.05);2组患儿置管7d后的WBC、PLT值比较,差异均无统计学意义(P>0.05);置管7d后对照组血小板下降发生率明显高于试验组,凝血酶时间明显长于试验组,差异有统计学意义(P<0.05)。结论无肝素化在新生儿PICC的应用,可有效减少置管过程中持续使用肝素所造成的血小板减少等并发症,方便导管维护,从而降低置管风险。Objective To investigate the effect of heparin-free PICC in neonates. Methods 723 neonates were randomly divided NICU 402 experimental group and 321 control group.On the basis of continuous infusion,The control group used 20 ml syringes to extract normal saline 2~3 ml pulse to flush the PICC catheter daily,Then 20 ml syringe was used to extract 1~2 light heparin solution(1 U/ml)pulse flushing catheter,and add light heparin [10 U/(kg·m L)]into the large liquid continuously pump in;The experimental group used 20 syringes to extract normal saline 3~5 ml pulse irrigation PICC catheter when changing large liquid daily;The time of catheter indwelling,the incidence of complications such as tube plugging,phlebitis,infection and platelet count were compared between the two groups.Results There was no significant difference between the two groups(P>0.05);Comparison of WBC、PLT values between the two groups after 7 days of catheterization,All differences were not statistically significant(P>0.05);After 7 days of catheterization,the incidence of thrombocytopenia in the control group was significantly higher than that in the experimental group,difference was statistically significant(P<0.05).Conclusion The application of heparin-free in neonatal PICC,effectively reducing complications such as thrombocytopenia caused by the continuous use of heparin during catheterization,Convenient catheter maintenance,Well done,Thus reducing the risk of tube placement.

关 键 词：新生儿 PICC 无肝素化 应用效果 

分 类 号：R473.72[医药卫生—护理学]