周围中心静脉导管在极低体重儿运用的临床对照观察  

The clinical control observation of peripheral inserted central catheter on very low birth-weight infants

作　　者：罗先琼[1] 王晓东[1] 黄水清[1] 罗爱明[1] 

机构地区：[1]广东省妇幼保健院新生科,广州510010

出　　处：《中国实用儿科杂志》2003年第3期146-148,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　探讨经皮插入中心静脉导管 (PICC)在极低体重儿 (VLBW )运用的临床价值。方法　采用经皮插入中心静脉导管治疗 40例极低体重儿 ,并与同期运用外周静脉穿刺术 (PIV)治疗的 3 7例极低体重儿进行临床观察。结果　PICC组与PIV组比较 :穿刺次数、住院时间减少 ,结果具有显著性差异 ;静脉运用时间、血培养阳性率及病死率无显著性差异。入院 3 0d两组体重比较 ,结果具有显著性差异 ;两组肝功能、肾功能、血电解质、血脂异常及高血糖的发生率无显著性差异 ,而低血糖的发生率具有显著性差异 ;PICC组 40例拔管的原因 ,其中不再需要 2 1例、感染 5例、机械并发症 6例、死亡 4例及其它 4例。结论　PICC可以方便的提供极低体重儿静脉营养 ,顺利过渡到胃肠道喂养 ;PICC减少了极低体重儿静脉穿刺的次数 ,从而减少人为的过度刺激 ,降低氧和能量的消耗 ;PICC可以使极低体重儿体重增长迅速 ,减少住院时间 。Objective To study the clinical value of peripherally inserted central catheter(PICC) on very low birth weight (VLBW) infants.Methods 40 VLBW infants were treated with PICC and then retrospective clinical control study was carried out between them and the 37 VLBW infants treated with peripheral intravenous (PIV) during the same period.Results Compared with PIV group,puncture times and length of stay were both decreased in PICC group,and the results had significant difference.However,there was no difference of the duration of venous catheter indwelling?the positive incidence of blood culture or death rate between the two groups.Body weight in PICC group at 30 days after hospitalization were greater than that in PIV group (P<0 05),but there was no marked difference of liver function?renal function?blood electrolyte?cholesterol and hyperglycemia between the two groups.As to the incidence of hypoglycemia,it decreased significantly in PICC group (P<0 05).The extubation causes of the 40 infants in PICC group were:being no longer needed(21)?infection(5)?machine complication(6)?death(4) and others(4).Conclusions PICC can provide parenteral nutrition in low birth weight infants conveniently before enteral feeding, and it can also reduce puncture times which results in less factitious stimulation.Moreover,the consumption of the oxygen and energy were both decreased by PICC;so it can increase the body weight of VLBW infants quickly but shorten their length of stay, which leads to a lower rate of complications.

关 键 词：周围中心静脉导管 极低出生体重儿 临床对照观察 

分 类 号：R722[医药卫生—儿科]