早产儿PICC最佳穿刺部位的探讨

目的探讨早产儿经外周静脉穿刺置入中心静脉导管(PICC)的最佳穿刺部位。方法分析2009年1月～2011年3月100例早产儿的PICC穿刺不同静脉的并发症发生情况和不同穿刺部位固定PICC的透明敷贴更换频率。结果早产儿穿刺不同的静脉在PICC的并发症方面,贵要静脉与其它静脉比较并发症最少,差异有统计学意义(P<0.01);早产儿PICC不同穿刺部位7天内需更换敷贴的情况比较:PICC穿刺点在前臂中点上下二横指范围的静脉与内踝大隐静脉比较差异无统计学意义(P>0.05)。这2个穿刺部位与其它穿刺部位相比较更换敷贴频率少,差异有统计学意义(P<0.01)。结论早产儿的前臂中点上下二横指范围的贵要静脉是最佳穿刺部位,以右侧肢体为首选。并发症最少,维护操作最便捷。

Objective To investigate the best venipuncture position of the Peripherally Inserted Central Catheter（PICC） in premature infant.Methods We explored the situation of complications among different puncture veins and the replacement of transparent applications among different puncture positions by analyzing the puncture position and vein of 100 premature infants in our department from January 2009 to March 2011.Results The replacement of transparent applications（〈7 days after puncture） between vein in the range of 2 fingers from the middle point of forearm and saphenous vein didn’t show a significantly different（P〉0.05） ,but this two positions indicated a significantly different（P〈0.01） compared to other veins.between basilica vein and other veins,the situation of complications about premature infant with PICC indicated a significantly different（P〈0.01） .Conclusion The basilica vein in the range of 2 fingers from the middle point of the right forearm is the best choice for the PICC in the reason of the least complication and the most convenience in preservation.