床旁高频彩色多普勒超声在低出生体重早产儿上肢PICC导管尖端定位中的应用

The role of high frequency color doppler ultrasonography to position PICC catheter tips in low birth weight prematures

目的探讨床旁高频彩色多普勒超声在新生儿重症监护病房低出生体重早产儿上肢PICC导管尖端定位中的作用。方法 33例低出生体重早产儿,分别行床旁X线胸片及高频彩色多普勒超声检查,观察导管尖端的位置。对于异位入右心房或对侧无名静脉的PICC导管,应用超声测量尖端与左右无名静脉汇合处的距离,或尖端到上腔静脉与右心房连接处的距离,计算需退管的长度。结果 33例患儿中,超声清晰显示导管尖端者30例(90.90%),X线摄片清晰显示导管尖端者17例(51.51%),两组比较,差异有统计学意义(P<0.05)。异位入右心房及对侧锁骨下静脉的病例,均在超声指导下退管至理想位置,退管成功率100%。结论高频彩色多普勒超声是PICC导管尖端安全简捷的定位方法之一。

Objective To explore the role of high frequency color doppler ultrasonography to position the PICC catheter tips in the upper limb of low birth weight prematures in NICU.Methods 33 cases of low birth weight prematures were performed by the bedside chest X-ray and high frequency color doppler ultrasonography to observe the position of the catheter tip.Applying ultrasonic to measure the distance between the tip and the unknown venous confluence,or the distance from the tip to where the superior vena cava joints to th right atrium for whose PICC catheter ectopic in unknown vein or the right atrium,and that＇s the length for the catheter tips were back up.Results In the 33 cases,ultrasound clearly showed catheter tips of 30 patients （90.90%）,X-ray radiography displayed catheter tips of 17 cases （51.51%）,was statistically significant between the two groups （chi-square = 12.490,P = 12.490）.The patients who were in the right atrium and the subclavicular vein were all retreated to the ideal position under the guidance of ultrasonographic,and the success rate was 100%.Conclusion high frequency color doppler ultrasonography is one of the safe and easy methods to locate PICC catheter.