经外周中心静脉导管置入术在极低出生体重儿中的应用

Application of peripherally inserted central catheter for very low birth weight infants

目的探讨外周刺中心静脉导管、（PICC）置管术在极低出生体重儿（VLBW）中应用的临床意义及价值。方法将98例极低出生体重儿随机分为实验组48例，行PICC置管，对照组50例，行周围静脉留置针，比较两组穿刺次数、留置时间、并发症发生情况及体重变化情况。结果实验组住院期间输液穿刺次数为（6．13±1．4），留置时间为（28．5±4．6）d；对照组穿刺次数为（27．52±6．5）次，留置时间为（2．9±0．4）d，差异均有统计学意义（t分别为14．3，15．1；P〈0．01）；实验组导管机械性并发症总发生率为10．4％，对照组为48．0％，差异有统计学意义（χ2=16．6，P〈0．01）；实验组无一例发生低血糖，每3天体重增长值大于对照组（P〈0．05）。结论PICC为需要中长期静脉治疗的极低出生体重儿提供了安全、可靠的静脉通路。

Objective To investigate the clinical significance and value of peripherally inserted central catheter （PICC） used in very low birth weight infants （VLBW）. Methods 98 very low birth weight infants were divided into two groups. PICC was used in the experimental group with 48 cases, whereas peripherally intravenous catheter infusion （PIV） was used in the control group with 50 cases. The results were compared with their clinical information. Results The times of transfusion puncture in experimental group was significantly lower than the control group [ （6.13 ±1.4） vs （27.52 ±6. 5） ; t = 14.3, P 〈0. 01 ]. The mean indwelling time of catheters in the experimental and the control groups was （28.5 ± 4.6 ） days and （2.9 ± 0.4 ） days respectively. The difference of the indwelling time was statistically significant （ t = 15.1, P 〈 0. 01 ）. Significant differences between the rate of mechanical complications were also observed （ 10.4% vs 48.0% ; χ2 = 16.6, P 〈0.01 ）. Incidence of hypoglycemia （0 and 8 for the experimental group and control group respectively, χ2 = 18.2, P 〈 0.01 ） and average weight gain every 3 days were both significantly different （ P 〈 0.05 ）. Conclusions PICC provides a safe and reliable venous access for very low birth weight infants who requires medium-and long-term intravenous treatments.