床边B超定位在脐静脉置管术中的应用价值

Application value of bedside real-time ultrasonography in umbilical venous catheters

目的探讨床边B超定位在脐静脉置管术(UVC)中的应用价值。方法选择2016年11月至2017年4月在安徽省立医院儿科新生儿病房行UVC的58例患儿,分析B超下导管末端位置与其对应X线检查位置情况,比较B超与X线检查定位导管末端位置、实际导管置入深度与预测深度的差异。结果 B超下导管末端位置位于心房及下腔静脉和右心房连接处(目标位置)时,其X线检查对应椎体范围分别是T5~T9和T7~T9。B超与X线检查定位导管末端位置结果进行比较,差异有统计学意义(χ~2=4.35,P=0.04)。导管实际置入深度与预测深度相比,差异有统计学意义(P<0.05)。结论床边B超定位在新生儿UVC中,可直观引导及定位导管尖端位置,值得临床推广。

Objective To explore the application value of bedside real-time ultrasonography in umbilical venous catheter(UVC).Methods Fifty-eight cases requiring UVC from November 2016 to April 2017,who were hospitalized in NICU,Anhui provincial hospital,wererecruited in this prospective,self control study.The relationship between the actual position catheter and its corresponding X position was analyzed.The difference between two ways of estimating catheter location,and the difference between actual depth and prediction were compared.Results Catheter tip position in the atrium and the junction of inferior vena cava with the right atrium(target area)was T5-T9,T7-T9 respectively.The way of checking tip position between ultrasound and X-ray was statistically significant(χ2=4.35,P=0.04).The difference between actual insert depth and prediction depth was statistically significant(P<0.05).Conclusion Insertion of the UVC with bedside real-time ultrasound,which provides direct visualization,is more adequate and can be performed by the neonatologists in charge of the procedure.