一例早产儿下肢静脉机化物形成致PICC拔管困难的处理体会

One case of PICC decannulation difficult processing experience due to lower limb vein organic compound formation in preterm neonate

目的分析1例早产儿下肢静脉机化物形成致PICC拔管困难的原因和多学科合作的应用。方法通过对PICC拔管困难进行原因分析和处理,在多学科合作综合干预下拔管。结果患儿在数字减影血管造影下成功拔除PICC,但腘静脉内机化物残留,随访6个月无机化物脱落、血管堵塞等不良后果。结论新生儿PICC拔管困难,可给予合适体位、湿热敷、局部按摩等方法,必要时B超确认有无血栓、机化物及纤维蛋白鞘形成等,应用多学科合作能提高最小创伤拔管成功率,针对拔管困难的原因采取有效的预防措施是PICC置管护理的重点。

Objective To analyze the decannulation difficult reason and the application of multidisciplinary cooperation of 1 case of premature neonate with leg vein organic compound formation.Methods Through the PICC decannulation difficult reason analysis and processing,drawing tube under multidisciplinary cooperation comprehensive intervention.Results Children managed to root out PICC under digital subtraction angiography(DSA),but organic compound in the popliteal vein remained.No organic compound falling off and blood clots occurrd after 6-month follow-up.Conclusion For neonatal PICC decannulation difficult,we can give appropriate postures,wet hot compress,local massage method,as well as ultrasound for confirmation of presence of thrombus when necessary,such as machine compound and fibrin sheath formation.Application of multidisciplinary cooperation can improve the success rate of minimally invasive decannulation.According to the cause of decannulation difficult and take effective preventive measures is the key point of PICC catheter nursing.