腔内心电图定位新生儿脐静脉导管尖端效果的临床观察  

Clinical Observation on the Effect of Locating the Tip of Umbilical Vein Catheter in Newborns by Intracavitary Electrocardiogram

作　　者：付马 付小伟 高艳[1] 金瑞 Fu Ma;Fu Xiaowei;Gao Yan(Neonatology Department,Lianyungang Maternal and Child Health Hospital,Lianyungang,Jiangsu,222000,China)

机构地区：[1]连云港市妇幼保健院新生儿科,江苏连云港222000

出　　处：《黑龙江医学》2024年第10期1180-1182,共3页Heilongjiang Medical Journal

基　　金：江苏省卫生健康委员会医学科研立项面上项目(Z2021075)。

摘　　要：目的:观察腔内心电图定位技术在新生儿脐静脉导管尖端异位中的应用效果。方法:回顾性分析2019年1月—12月连云港市妇幼保健院采用传统方法计算置入脐静脉导管尖端位置的70例新生儿为对照组,以2020年1月—12月采用腔内心电图定位技术定位脐静脉导管尖端位置的62例新生儿为观察组,两组患儿置入脐静脉导管术后通过床旁X线胸片定位了解导管尖端的位置,比较两组患儿置入后导管尖端异位(位置异位、尖端过深异位、尖端过浅异位)发生率。结果:对照组患儿8例导管尖端进入肝内静脉,观察组患儿1例肝内静脉异位,差异有统计学意义(χ^(2)=5.37,P<0.05);对照组患儿1例误入脐动脉,观察组患儿1例误入脐动脉,差异无统计学意义(χ^(2)=0.10,P>0.05);观察组患儿1例位置过深,对照组患儿11例位置过深,观察组患儿位置过深明显较对照组多,差异有统计学意义(χ^(2)=13.26,P<0.05);观察组患儿8例位置过浅,对照组患儿1例位置过浅,对照组位置过浅发生率明显降低,差异有统计学意义(χ^(2)=5.37,P<0.05)。结论:采用腔内心电图定位技术在置入过程中可提前发现尖端异位,能在置入过程中降低脐静脉导管尖端异位发生率。Objective:To observe the effect of the localization of IEGM in neonates with ectopic tip of umbilical vein catheter.Methods:Tip position of the umbilical vein catheter in 70 cases completed from January to December 2019 in the hospital was retrospectively analyzed and regarded as the control group.62 cases from January 1,2020 to December 31,2020 under the location of the tip position of the umbilical vein catheter with the electrocardiography localization technology were regarded as the observation group.After the umbilical vein catheter was placed in the two groups,the tip position of the catheter was determined by the bedside chest X-ray localization.The incidence of ectopic tip of catheter(ectopic position,too deep ectopic tip and too shallow ectopic tip)was compared between the two groups.Results:8 cases in the control group had the tip of the catheter entering the internal hepatic vein,and 1 case in the observation group had the umbilical artery by mistake,with statistically significant differenc(χ^(2)=5.37,P<0.05).1 case in the control group entered the umbilical artery by mistake,and 1 case in the observation group had umbilical artery by mistake,with statistically significant difference(χ^(2)=0.10,P>0.05).1 case in the observation group was too deep,and 11 cases in the control group were too deep.The position in the observation group was significantly deeper than that in the control group,with statistically significant difference(χ^(2)=13.26,P<0.05).8 cases in the observation group were too shallow,1 case in the control group was too shallow,and the incidence of too shallow in the control group was significantly reduced,with statistically significant difference(χ^(2)=5.37,P<0.05).Conclusion:Intraluminal ECG localization technique can detect ectopic tip in advance during the insertion process,and reduce the incidence of ectopic tip of umbilical vein catheter during the insertion process.

关 键 词：新生儿 脐静脉置管术 腔内心电图 导管尖端异位 

分 类 号：R272.1[医药卫生—中医儿科学]