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目的 研究儿童重症监护病房 (PICU)经桡动脉、股动脉和尺动脉不同置管途径及相关并发症 ,以确定尺动脉作为外周替代性血管置管的可行性。对象和方法 对一所三级儿童治疗中心既往 4年PICU 0 4～ 36个月的所有尺动脉、桡动脉或股动脉置管的 12 4例危重病住院患儿进行回顾性研究。尺动脉和桡动脉导管型号分别为 2 2 ga和 2 4 ga ,股动脉导管用 2 5 Fr 2 5cm或 3 Fr 5cm。所有导管均经皮插入。若常规外周部位置管失败则改用尺动脉。结果共有尺动脉置管 18例、桡动脉置管 10 3例和股动脉置管 6 9例纳入本研究。置管时间 :尺动脉 1～ 19d[平均 (4 2± 4 2 )d],桡动脉 1～ 2 4d[平均 (5 3± 4 2 )d],股动脉 1～ 2 1d[平均 (6 9± 4 5 )d]。尺动脉、桡动脉和股动脉因缺血终止置管者分别为 5 6 %、 3 9%和 8 7% ;导管相关感染率分别为 0 %、0 97%和 4 3%。结论 根据尺动脉缺血和感染的发生率 ,我们认为常规部位置管失败而又必须动脉置管时 ,可选用经尺动脉外周置管
Objective To study the different approach of catheterization and related complications in the pediatric intensive care unit (PICU) via radial artery, femoral artery and ulnar artery to determine the feasibility of ulnar artery as an alternative vascular catheter. Subjects and Methods A retrospective study was conducted on 12 4 critically ill children hospitalized with all ulnar, radial, or femoral arterial catheters in a 4-year PICU from a tertiary child care center. The ulnar and radial catheter models were 2 2 ga and 2 4 ga respectively, and the femoral artery catheter was 2 5 Fr 2 5 cm or 3 Fr 5 cm. All catheters are percutaneously inserted. If the conventional peripheral tube failed to use the ulnar artery. Results There were 18 cases of ulnar artery catheterization, 103 cases of radial artery catheterization and 69 cases of femoral artery catheterization. The duration of catheterization was 1 to 19 days in ulnar arteries (42 ± 42 days) on average, 1 to 24 days in radial arteries (53 ± 42 days) and 1 to 21 days in femoral arteries ± 4 5) d]. The rates of catheter-related infection were 56%, 39% and 87%, respectively, in ulnar artery, radial artery and femoral artery. The catheter-related infection rates were 0%, 97% and 43% respectively. Conclusion According to the incidence of ulnar artery ischemia and infection, we believe that the conventional part of the catheter failed and must be arterial catheterization, the catheter can be selected through the peripheral arteries