PICC相关新生儿胸腔积液2例并文献复习  

Peripherally Inserted Central Catheter Related Pleural Effusion in Neonates:an Analysis on 2 Cases and Literature Review

作　　者：陈誉 唐彬秩[2] 刘禹岑 沙群芳 李茂军[2] CHEN Yu;TANG Bin-zhi;LIU Yu-cen;SHA Qun-fang;LI Mao-jun(School of Medical and Life Sciences,Chengdu University of Traditional Chinese Medicine;Department of Pediatrics,Sichuan Academy of Medical Sciences&Sichuan Provincial People’s Hospital,Chengdu 610072,China)

机构地区：[1]成都中医药大学医学与生命科学学院 [2]四川省医学科学院·四川省人民医院儿科,成都610072

出　　处：《实用临床医学（江西）》2024年第2期54-60,F0004,共8页Practical Clinical Medicine

摘　　要：目的探讨新生儿经外周静脉置入中心静脉导管(PICC)并发胸腔积液的临床特点、病因及防治措施,为临床诊治PICC相关新生儿胸腔积液提供依据。方法回顾2例新生儿PICC置管并发胸腔积液的临床资料,并以关键词“经外周静脉置入中心静脉导管”“胸腔积液”“PICC并发症”“peripherally inserted central catheter”“neonatal”“pleural effusion”“PICC complications”搜索中国知网(CNKI)、中华医学期刊全文数据库、PubMed、Web of science、Embase等数据库,检索2010年1月至2023年6月收录的文献。总结新生儿PICC相关胸腔积液的临床特点、治疗及预后。结果2例患儿均在PICC置管情况下突发呼吸困难,影像学检查及胸腔穿刺证实为PICC导管渗出性胸腔积液发生,通过立即拔除PICC导管以及行胸腔穿刺,胸腔积液吸收,经积极治疗后均治愈出院,预后良好。纳入文献16篇,总计53例患儿进行分析。53例患儿均为早产儿,除1例出生体重不详外,其余52例患儿均为低出生体重儿,其中极低出生体重儿44例,比例约80.2%,超低出生体重儿占比约11.3%。除1例未具体说明置管穿刺点外,其余52例患儿中,选择经上肢静脉置比例94.2%,下肢为3.8%。除8例未具体说明导管尖端位置外,其余病例中80%发生异位,以远心端方向异位居多,占比77.8%。结论新生儿PICC可并发胸腔积液,临床需引起重视并及时防范,正确处理,一般预后良好。Objective To explore the clinical characteristics and pathogenesis,prevention and treatment of peripherally inserted central catheter(PICC)related pleural effusion in neonates,and provide a theoretical basis for clinical management of neonatal PICC-related pleural effusion.Methods The clinical data of pleural effusion in 2 neonates with PICC placement were retrospectively analyzed.We searched the databases of China Knowledge Network(CNKI),Chinese Medical Journal Full Text Database,PubMed,Web of science,Embase,and so on,and retrieved the literature from January 2010 to June 2023.We summarized the clinical characteristics,treatment and prognosis of neonatal PICC-related pleural effusion.Results Both cases had sudden dyspnea in the presence of PICC placement;imaging examination and thoracentesis confirmed the occurrence of PICC leakage pleural effusion;pleural effusion was absorbed by immediately removing PICC and performing thoracentesis;after active treatment,both neonates were discharged with good prognosis.16 articles were included in the literature and a total of 53 children were analyzed.53 children were born prematurely,and except for one case in which the birth weight was not specified,the remaining 52 children were of low birth weight,of which 44 were of very low birth weight,a proportion of approximately 80.2%,and the proportion of ultra-low birth weight children was approximately 11.3%.Except for 1 case in which the puncture point for catheterization was not specified,the proportion of the remaining 52 cases who chose to have the catheter placed through the veins of the upper extremities was 94.2%,and the proportion of the lower extremities was 3.8%.Except for 8 cases in which the location of the catheter tip was not specified,80%of the remaining cases were ectopic,with the distal direction accounting for the majority of ectopic cases(77.8%).Conclusion Attention should be paid to PICC-related pleural effusion in neonates,and the prognosis can be generally desirable when it is prevented timely and interven

关 键 词：经外周静脉置入中心静脉导管 胸腔积液 PICC并发症 新生儿 

分 类 号：R722.1[医药卫生—儿科]