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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 ,而并发症的发生率低
Objective To investigate the clinical value of percutaneously inserted central venous catheter (PICC) in the treatment of very low birth weight children (VLBW). Methods Percutaneous central venous catheterization was used to treat 40 cases of very low birth weight infants and 37 cases of extremely low birth weight infants were treated by peripheral venipuncture (PIV) during the same period. Results PICC group and PIV group: the number of punctures, hospital stay decreased, the results showed significant differences; venous time, blood culture positive rate and mortality no significant difference. There were significant differences between the two groups on the 30th day after admission. There was no significant difference in the incidence of liver function, renal function, serum electrolytes, dyslipidemia and hyperglycemia between the two groups, but the incidence of hypoglycemia was significantly different. PICC Among the 40 patients who underwent extubation, 21 were no longer needed, 5 were infected, 6 were mechanical complications, 4 were fatal and 4 were other. Conclusion PICC can facilitate the delivery of very low birth weight infants and successfully transit to gastrointestinal tract. PICC can reduce the number of venous punctures in very low birth weight infants, thereby reducing the artificial overstimulation and reducing the consumption of oxygen and energy. PICC can make Very low birth weight children weight gain rapid reduction in hospital stay, and the incidence of complications is low