超声引导下按压右上腹在新生儿脐静脉置管中的应用  

Application of ultrasound-guided compression of the right upper abdomen in neonatal umbilical vein catheterization

作　　者：杨婷[1] 张雪芬 陈冠初 高红霞[1] 丁晓华[1] 殷婷婷 YANG Ting;ZHANG Xuefen;CHEN Guanchu;GAO Hongxia;DING Xiaohua;YIN Tingting(Department of Neonatology,Gansu Province Maternity and Child Health Hospital,Gansu Province,Lanzhou,730050,China)

机构地区：[1]甘肃省妇幼保健院新生儿科,甘肃兰州730050

出　　处：《中国当代医药》2023年第24期97-100,共4页China Modern Medicine

基　　金：甘肃省兰州市科技发展指导性计划项目(2020-ZD-11)。

摘　　要：目的探讨超声引导下按压右上腹在新生儿脐静脉置管(UVC)中的应用效果。方法选取2020年1月至2021年3月甘肃省妇幼保健院新生儿科收治的113例符合UVC纳入标准新生儿,根据住院尾号单双分为观察组(54例)与对照组(59例)。两组在UVC前均床旁超声测量门静脉左支矢状部与静脉导管夹角(AsLPVDV),操作时观察组采用超声引导下按压右上腹进行置管,尽可能使AsLPVDV增大至180°,对照组采用常规置管。比较两组的AsLPVDV、UVC一次性成功率、UVC总体成功率、置管时间和置管后并发症发生率。结果观察组按压腹部后的AsLPVDV大于对照组,UVC一次性成功率及UVC总体成功率高于对照组,置管时间短于对照组,置管相关门静脉积气发生率低于对照组,差异有统计学意义(P<0.05)。结论超声引导下按压右上腹可使AsLPVDV增大,提高UVC成功率、缩短置管时间、减少置管相关并发症的发生,可在临床推广应用。Objective To explore the application effect of ultrasound-guided compression of the right upper abdomen in neonatal umbilical vein catheterization(UVC).Methods A total of 113 neonates who met the inclusion criteria for UVC were selected from the Department of Neonatology of Gansu Province Maternity and Child Health Hospital from January 2020 to March 2021,they were divided into observation group(54 cases)and control group(59 cases)according to the odd-even hospitalization tail number.Both groups measured the angle between sagittal part of left portal vein and ductus venosus(AsLPVDV)by bedside ultrasound before UVC.During the operation,the observation group used ultrasound-guided compression of the right upper abdomen for catheterization,maximizing the AsLPVDV to 180°as much as possible.The control group received routine catheterization.The AsLPVDV,one-time success rate of UVC,overall success rate of UVC,catheterization time and incidence of complications after catheterization were compared between the two groups.Results The AsLPVDV of the observation group after abdominal compression was greater than that of the control group,the one-time success rate and overall success rate of UVC were higher than those of the control group,the catheterization time was shorter than that of the control group,the incidence of portal vein gas accumulation related to catheterization was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusion Ultrasound-guided compression of the right upper abdomen can increase AsLPVDV,improve the success rate of UVC,shorten the catheterization time and reduce the occurrence of catheter-related complications.It can be widely promoted and applied in clinical practice.

关 键 词：脐静脉置管 新生儿 超声 腹部按压 

分 类 号：R72[医药卫生—儿科]