经外周中心静脉置管在早产儿及危重新生儿中的应用及护理

The application and nursing care of the PICC in premature children and intensive newborns

目的探索PICC插管技术在早产儿及危重新生儿中的应用。方法对在新生儿科住院的早产儿及危重新生儿130例,使用PICC插管技术,经贵要静脉穿刺80例,腋静脉40例,肘正中静脉5例,头静脉3例,窝静脉2例。结果置管成功129例,失败1例。平均留置时间为18 d。发生机械性静脉炎5例,堵管13例,因堵管拔管1例。意外拔管1例,导管尖端异位5例。结论 PICC置管为危重新生儿尤其是早产儿及极低出生体重儿提供了可靠安全的中长期静脉通道,保证药物及营养的供给,减轻了护理工作量,减少因反复穿刺给患儿带来的疼痛刺激,是有效抢救极低体重儿、超低体重儿不可缺少的技术。

Objective To explore the application of the PICC in premature children and in-tensive newborns.Methods The analysis of 130 cases of premature children and intensive new-borns who had used the PICC in the period November 2007 to March 2010 in Jiangyin People′s Hospital.Results Totally 80 cases through basilic vein,40 cases of auxiliary vein,median cubital vein in 5 cases,3 cases of cephalic vein,popliteal vein in 2 cases,and then 129 cases of catheteriza-tion success and failure in 1 case.The average retention time was 18 days.Mechanical phlebitis oc-curred in 5 cases,plugging in 13 cases,1 case due to plugging extubation.Accidental extubation in 1 case,5 cases of ectopic catheter tip.Conclusions PICC in intensive neonates,especially for the premature children and very low birth weight children,provided a reliable and secure long-term in-travenous access,which could ensure the supply of drugs and nutrition,reduce the nursing workload and children′s pain stimulation by repeated puncture.It is an indispensable technology for salvage very low birth weight and extremely low weight birth children effectively.