极低出生体质量儿建立静脉输液通路方式的比较

Comparison of Different Intravenous Administration Routes in Very Low Birth Weight Infants

目的探讨极低出生体质量儿建立静脉输液通路的最佳方式。方法将极低出生体质量儿81例分为联合导管组(采用脐静脉置管联合外周中心静脉置管)和外周静脉组,比较两组患儿住院过程中静脉穿刺次数、建立静脉通路所使用的时间、导管留置时间、操作期间血氧饱和度下降(低于80%)次数、体质量增长情况、输液外渗例数及血培养情况。结果联合导管组在静脉穿刺次数和建立静脉通路所使用的时间、建立静脉通路过程中血氧饱和度下降的次数、输液外渗次数少于外周静脉组,比较差异有统计学意义;联合导管组留置时间长,患儿住院期间体质量增长快,比较差异有统计学意义;两组感染发生率比较差异无统计学意义。结论联合脐静脉置管和外周中心静脉置管进行极低出生体质量儿输液管理,穿刺成功率高,留置时间长,刺激少,利于患儿的体质量增长值得推广应用。

Objective To explore the best route of venous administration in very low birth weight infants. Methods 81 cases were divided into the observation group and the control group. The observation group received umbilical vein catheterization and peripherally inserted central catheterization, and the control group, peripheral venous indwelling needle puncturing. A comparison was made of the times of venipuncture, time spent on building the vein route, duration of catheter stay, times of SO2 decrease to below 80%, body weight gaining, number of cases of extravasation and blood culturing between the two groups. Results The times of venipuncture, times of SO2 decrease during the building of the vein routes and the number of cases of extravasation among the observation group were fewer than those among the control group, with the differences being statistically significant. The time spent on building the vein route, the duration of catheter stay of the observation group were longer, and the body mass increased more quickly, than the other group, the difference having statistical significance. The differences in the rates of infection incidences of the two groups were not statistically significant. Conclusion Umbilical vein catheterization combining with peripherally inserted central catheterization in infusion for very low birth weight infants, has a higher rate of success of venipuncture, with a greater duration of catheter stay but less stimulation, and is thus conducive to the increase of the newborn＇ s body mass and worth popularization.