影响低出生体重儿PICC非正常拔管的多因素分析

Multiple factors analysis for abnormal removal of peripherally inserted central catheter in low birth weight infants.

目的:分析影响低出生体重儿经外周静脉置入中心静脉导管非正常拔管的相关因素。方法:回顾性分析2009年4月～2010年4月我科27例低出生体重儿行外周中心静脉置管术护理状况及应用效果。结果:本研究中穿刺成功27例,穿刺成功率100%。正常治疗结束拔管15例(正常拔管组),非正常治疗结束拔管12例(非正常拔管组)。出现相关并发症堵管6例,静脉炎4例,渗漏4例,穿刺点渗血6例,穿刺侧肢体肿胀5例,导管脱出2例,心律失常1例。非正常拔管组渗漏及静脉炎发生率均为33.3%,正常拔管组均为0,两组间比较差异有统计学意义(Fisher's精确概率计算值均为0.028)。导管平均留置时间与血小板含量及平均脂肪乳浓度无相关性(P>0.05)。结论:渗漏及静脉炎是影响低出生体重儿经外周静脉置入中心静脉导管非正常拔管的危险因素。

Objective： To analyze the risk factors related to abnormal removal of peripherally inserted central catheter（PICC） in low birth weight（LBW） infants.Methods： Multiple risk factors of abnormal removal of PICC were analysed retrospectively in 27 LBW infants who were treated by peripherally inserted central catheter therapy from April 2009 to April 2010.Results： PICC procedure were performed successfully in 27 LBW infants during that time.Compared with normal tube-removal group infants（n=15） whose tubes were withdrew at the end point of therapy,the risk factors of abnormal tube-removal of PICC tubes were included tube blocked（6 cases）,phlebitis（4 cases）,extravasation（4 cases）,puncture point bleeding（6 cases） and tumefaction of the affected limb（5 cases）.Significant differences were found that the prevalence rates of extravasation and phlebitis in abnormal removal group（33.3% respectively） were higher than in normal removal group（0%）.No significance was found that the relationship between average time of catheter retention and average platelet content or average fat emulsion concentration（P0.05）.Conclusion： Extravasation and phlebitis were the risk factors causing abnormal removal of PICC tube in LBW infants.