肝素预防新生儿经外周中心静脉置管相关感染的回顾性研究

The Role of Heparin in Prevention of Neonatal Catheter-related Complications in Peripherally Inserted Central Catheters

目的观察全合一静脉营养液中加入小剂量肝素持续输注对新生儿经外周导入中心静脉置管(PICC)相关感染的预防作用。方法将我院新生儿重症监护病房2007.5～2008.12行PICC置管的103例患者分为两组:肝素组(n=63)在全合一营养液中加入肝素0.5U/mL,对照组(n=40)不加肝素,回顾性分析比较两组导管相关性败血症(CRI)发生情况。结果肝素组发生导管堵塞4例(6.3%),导管内细菌定植1例(1.58%),导管相关血流感染0例;对照组发生导管堵塞8例(20%),导管内细菌定植7例(17.5%),导管相关血流感染5例(12.5%),两组比较其差异均有统计学意义(P<0.05)。结论静脉营养液中加入0.5U/mL的肝素可减少PICC堵管,预防导管相关感染发生。

Objective To investigate the role of low-dose heparin added to total nutrient admixture （TNA） solutions in the prevention of catheter related infections （CRIs）.Methods One-hundred three newborn infants with peripherally inserted central catheter （PICC） were divided into heparin group （n=63） and control group （n=40）.The patients in the heparin group received TNA with 0.5 U/ml heparin.The patients in the control group received TNA without heparin.We retrospectively analyzed the incidence of CRTs in the two groups.Results We found that the incidence of CRIs was 0 in the heparin group and 12.5% （5/40） in the control group.The incidence of catheter obstruction was 6.3% （4/63） in the heparin group and 20% （8/40） in the control group.The incidence of catheter-tip colonization was 1.58% （1/40） in the heparin group and 17.5% （7/40） in the control group.The incidences of CRIs,catheter obstruction,and catheter-tip colonization were significantly lower in the heparin group than those in the control group （P0.05）.Conclusion TNA solutions with 0.5U/ml heparin have decreased catheter obstruction and CRIs.