低出生体重儿不同PICC置管途径并发症的比较分析

Analysis of complications of different PICC method in low weight infants

目的观察经贵要静脉、肘正中静脉、头静脉等5种不同途径经PICC置管并发症发生情况,寻找最佳的穿刺途径。方法对1516例低出生体重儿不同PICC置管途径并发症发生情况进行总结和分析,比较各种并发症发生率的差异。结果 1516例低出生体重儿总导管日为41 237 d,导管相关并发症总发生率为8.03/1000导管日。低出生体重儿PICC不同置管途径并发症总发生率比较,差异有统计学意义(P<0.05)。经下肢静脉置管后并发静脉炎、血栓、导管栓塞及导管相关血流感染(central line-associated bloodstream infection,CLABSI)发生率较高,其次是头静脉、正中静脉,经贵要静脉及腋静脉的并发症发生率相对较低(P<0.05)。结论 PICC在置管前对低出生低重儿血管情况的评估尤其重要,尽量选择并发症较低的静脉途径,将腋静脉、贵要静脉作为首选途径;同时做好各种并发症的预防,可以有效降低并发症的发生。

Objective To observe the occurrence of complications with difference PICC methods and find out the best puncture measure. Method Data based on 1516 cases of low birth weight in infants on different ways of PICC were analyzed and different rates of complications were compared. Results Toally hospital stay for 1516 low birth infants with catheter stay was 41 237 days and the catherter-related complication rate was 8 . 03/1000 . The different ways of complications were compared with statistical difference （P〈0.05）. The veins of lower extremity with PICC on complication of phlebitis, blood clots, catheter embolization and central line-associated bloodstream infection was high, while cephalic vein,median vein, axillary vein and basilic vein were low. Conclusions Enough evaluation on blood vessels of low birth infant before evaluation is important. Ways with less complication such as choosing axillary vein and basilic vein as priority, which can prevent and reduce complications.