不同外周静脉置入中心静脉导管置管途径应用于新生儿的效果对比及临床分析

The effect comparison and clinical analysis between the different PICC intubation pathways in the neonatal application

目的探讨上肢静脉与下肢静脉外周静脉置入中心静脉导管（PICC）置管途径在新生儿应用的效果对比，以寻求最佳置管途径。方法收集2012年3月～2013年3月在海南省人民医院诊治的120例PICC置管新生儿，随机将其分为对照组（上肢静脉）和观察组（下肢静脉），每组各60例，对两组出血量、操作时间、留置时间，一次穿刺成功率、导管异位发生率，以及置管并发症进行观察和比较。结果与对照组相比，观察组操作时间明显缩短[（25．0±10．0）min比（35．0±12．0）minl，一次性穿刺成功率明显升高（83.3％比66．7％），导管异位发生率显著降低（6．7％比25．0％），差异均有统计学意义（均P〈0．05），而出血量、留置时间、置管并发症发生率比较，两组差异无统计学意义（P〉0．05）。结论下肢静脉PICC置管较安全、可行，可尝试性常规选取。

Objective To study the effect comparison and clinical analysis between the upper limb vein and the lower extremity vein PICC intubation pathway in the neonatal application, and seek the better intubation pathway. Methods 120 neonatal with PICC intubation during the period from March 2012 to March 2013 were randomized into the control group （upper limb vein） and the observation group （lower extremity vein）, with 60 patients in each group. The bleeding volume, operation time, indwelling time, puncture success rate, the incidence of catheter heterotopias, and the catheter complications in the two groups were observed and compared. Results Compared with the control; the operation time significantly reduced [（25.0_＋10.0） rain vs （35.0：!：12.0） mini, the puncture success rate obviously increased （83.3% vs 66.7%）, the incidence of catheter heterotopias significantly decreased （6.7% vs 25.0%） with statistical difference in the observation group （P 〈 0.05）; the comparison of bleeding volume, indwelling time and the catheter complications be- tween the two groups were no statistical difference （P 〉 0.05）. Conclusion The lower extremity vein PICC intubation pathway is more safe and feasible, and can try to regard it as the conventional selection.