1例超低出生体重儿经外周静脉置入中心静脉导管置管后并发心包填塞的护理  

Nursing of a case of extremely low birth weight infant complicated with pericardial tamponade after peripherally inserted central catheter

作　　者：彭泽华[1] 陈旋 王敏 PENG Zehua;CHEN Xuan;WANG Min(Neonatal Intensive Care Unit,the Second Affiliated Hospital of Shantou University Medical College,Guangdong Province,Shantou 515154,China)

机构地区：[1]汕头大学医学院第二附属医院新生儿重症监护室,广东汕头515154

出　　处：《妇儿健康导刊》2024年第10期119-122,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：本文总结1例经外周静脉置入中心静脉导管(PICC)引起心包填塞的护理,以提高临床对本病的认识及预防。通过观察患儿局部与全身情况,采用胸部X线和心脏彩超进行检查,确诊患儿发生心包填塞及PICC异位,通过紧急行心包穿刺术,缓解心包填塞症状;及时拔除中心静脉置管,给予呼吸、循环、营养、重新置管等方面的支持治疗,并积极做好早产儿术后精细化护理。通过实施上述措施后,该患儿术后第7天心包腔无液性暗区、心影缩小,心率恢复正常,并在治疗68d后康复出院。积极预防深静脉导管并发症,在置管前应充分评估患儿,做好置管前准备。同时,置管及维护人员应具备丰富的临床经验,根据个体选择合适的置管方式、护理方案,才能降低不良事件发生率,保障置管的安全性。This paper summarizes the nursing of a case of pericardial tamponade caused by peripherally inserted central catheter(PICC),in order to improve the understanding and prevention of the disease in clinic.By observing the local and systemic conditions of the child,chest X-ray and cardiac color Doppler ultrasound were used to diagnose the child with pericardial tamponade and PICC malposition.Emergency pericardiocentesis was performed to relieve the symptoms of pericardial tamponade.The central venous catheter was removed in time,the respiratory,circulation,nutrition,re-catheterization,and other support treatments were given,and the postoperative fine nursing of premature infants was actively done.After the implementation of the above measures,the child’s pericardial cavity aneroid dark area and heart shadow were reduced,and his heart rate returned to normal on the 7th day after operation.He recovered and was discharged on the 68 days after treatment.The complications of deep venous catheter should be prevented actively.The children should be fully evaluated and prepared before catheterization.At the same time,the catheterization and maintenance personnel should have rich clinical experience,and choose the appropriate catheterization method and nursing plan according to the individual,so as to reduce the incidence of adverse events and ensure the safety of catheterization.

关 键 词：超低出生体重儿 经外周置入中心静脉导管 心包填塞 护理 

分 类 号：R473.72[医药卫生—护理学]