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目的探讨外周穿刺中心静脉导管在治疗极低出生体重儿的临床应用意义。方法采用1·9Fr规格外周穿刺中心静脉导管(peripherally inserted central venous catheter,PICC)对50例极低出生体重儿实施PICC置管,按照PICC护理常规进行护理。对留置结果和并发症进行回顾性研究。结果PICC留置时间为2~45d,平均(16·3±10·3)d,42%完成输液计划;PICC费用占总住院费用的2·6%,使用PICC完成37%补液疗程;PICC定位在上腔静脉组完成输液任务明显优于下腔静脉组和锁骨下静脉组;PICC导管定位准确性下肢静脉明显优于上肢静脉;主要并发症为:机械性静脉炎(发生率58%),静脉渗出(发生率22%),导管培养阳性(4·4%),血培养阳性(11·6%)。结论PICC对于极低出生体重儿是一种经济有效的静脉输液通路;导管定位在腔静脉是成功保留的关键,准确的定位将大大提高PICC的留置时间;加强护理可有效减轻机械性静脉炎的发生。
Objective To investigate the clinical significance of percutaneous puncture central venous catheter in the treatment of very low birth weight infants. Methods Fifty patients with very low birth weight were enrolled in a PICC catheter using a 1.9Fr peripherally inserted central venous catheter (PICC). The patients were followed up according to the PICC nursing routine. Retrospective study of indwelling outcomes and complications. Results The PICC retention time ranged from 2 to 45 days, with an average of (16 · 3 ± 10 · 3) days. 42% completed the infusion plan. The PICC cost accounted for 2.6% of the total hospitalization cost. PICC completed 37% rehydration treatment. The superior vena cava perfusion was superior to the inferior vena cava and subclavian vein in the superior vena cava group. The accuracy of PICC catheterization was superior to that of the upper limb vein. The main complications were mechanical phlebitis (incidence of 58%), (22% incidence), positive ductal culture (4.4%), and blood culture positive (11.6%). Conclusion PICC is a cost-effective intravenous solution for very low birth weight infants. Catheterization in the vena cava is the key to successful preservation. Accurate positioning will greatly improve PICC retention time. Intensifying nursing can effectively reduce the incidence of mechanical phlebitis occur.