新生儿下肢外周中心静脉导管相关并发症的影响因素分析

Influencing factors of complications related to PICC in neonatal lower limbs

目的分析新生儿下肢外周中心静脉导管(peripherally inserted central venous catheter,PICC)相关并发症的影响因素,并探讨防治对策。方法回顾性分析本院2012年6月至2018年6月收治的1066例行下肢PICC置管的新生儿的临床资料。按照PICC相关并发症发生情况,将其分别纳入并发症组和无并发症组,比较两组新生儿胎龄、出生体重、穿刺次数、留置时间等临床资料,采用多因素Logistic回归分析探讨新生儿下肢PICC相关并发症的影响因素。结果 1066例新生儿中,共有72例发生导管相关并发症,发生率为6.75%;以导管相关血行感染最为常见,占63.89%。多因素Logistic回归分析显示,出生体重< 2500 g、基础疾病为感染性疾病均为影响新生儿下肢PICC相关并发症的独立危险因素(P均< 0.05)。结论新生儿下肢PICC相关并发症的发生与出生体重、感染性疾病有关,临床上应重视高危新生儿的识别与干预。

Objective To analyze the influence factors of complications related to peripherally inserted central venous catheter (PICC) in neonatal lower limbs and explore the preventive and therapeutic strategies. Method The clinical data of 1066 neonates with PICC catheterization in lower limbs admitted to our hospital from June 2012 to June 2018 were analyzed retrospectively. According to the occurrence of PICC-related complications, they were included in complication group and non-complication group respectively. The clinical data such as gestational age, birth weight, puncture times and indwelling time were compared between the two groups. Multivariate Logistic regression analysis was used to summarize the relevant factors affecting complications of PICC in neonatal lower limbs. Result Among 1066 neonates, 72 cases had catheter-related complications (6.75%). Catheter-related bloodstream infection was the most common catheter-related complications (63.89%). Multivariate Logistic regression analysis showed that birth weight < 2500 g and infectious diseases were independent risk factors of complications related to PICC in neonatal lower limbs (Pall < 0.05). Conclusion The complications of PICC in neonatal lower limbs is related to birth weight and infectious diseases, and attention should be paid to the identification and intervention of high-risk neonates.