早产儿PICC置管时送管困难与导管异位关系观察

Relationships between catheter tip displacement and a difficult PICC insertion in premature infants

目的总结分析早产儿经外周静脉置入中心静脉导管(PICC)置管时送管困难与导管异位关系。方法回顾分析95例实施PICC置管的早产儿的临床资料,根据PICC置管时送管通畅与否分为送管通畅组和送管困难组,观察置管后导管末端位置。结果 61例早产儿PICC置管时送管通畅,其中发生导管异位8例,导管异位率为13.11%,34例PICC置管时送管困难,其中发生导管异位20例,导管异位发生率为58.82%,2组比较差异有统计学意义(χ2=21.943,P<0.01)。结论置管前认真评估,置管中送管受阻时综合分析受阻原因并采取相应对策是PICC置管成功的关键。

Objective To summarize and analyze relationships between tube delivery difficulties and catheter displacement during PICC for premature infants. Methods The clinical data of premature infants with PICC was retrospectively analyzed. They were divided into difficult insertion group（ 34 cases） and smooth insertion group（ 61 cases） according to the process of a PICC insertion. The catheter tip displacement was compared between the two groups. Results 8 cases were with catheter tip displacement in the smooth insertion group with an rate of 13. 11%（ 8 /61）,and 20 cases with catheter tip displacement in the difficult insertion group with an rate of 58. 82%（ 20 /34）,the difference was statistical significant between the two groups（ χ^2= 21. 943,P 〈0. 01）. Conclusion Nurses should perform a visual inspection of the PICC line insertion site and surrounding area with their initial assessment. The course analysis and countermeasures should be taken to solve the problems in a difficult insertion of PICC.