血管穿刺点的选择对早产儿PICC置管并发症影响的临床分析

Clinical Analysis of Effect of the Selection of Vascular Puncture Point on the Complications of PICC Catheterization in Premature Infants

目的:探讨早产低出生体重儿血管穿刺位点的选择对经外周静脉置入PICC导管后穿刺点的渗血时间、导管的移行的距离、置管后24 h导管滑动的例数。方法:128例患儿随机分为观察组与对照组。对照组的置管位置在血管最显露处进针;观察组置管位置在血管最显露处外0.5 cm处进针,导入鞘在皮下前行0.5 cm后从血管上方进针。分别记录置管后穿刺点渗血的例数、导管移行的距离、置管后24 h导管滑动的例数。结果:观察组置管后24 h明显渗血例数少于对照组,差异有统计学意义(P<0.05)。观察组导管移行距离(1.196±0.460)mm,对照组导管移行距离(1.875±0.500)mm,差异有统计学意义(t=7.7204,P<0.01)。观察组置管后24 h导管滑动≥5 mm例数明显于少于对照组,差异有统计学意义(P<0.05)。结论:早产儿PICC置管观察组较对照组能有效减少了穿刺点的渗血量,有效地降低导管的移行的距离,有效减少了导管滑动的例数,从而降低了早产儿PICC置管后并发症的发生。

Objective:To investigate the effect of selection of puncture site for premature low birth weight infants on the bleeding time of puncture site after PICC catheter is inserted through peripheral vein,the distance of catheter migration,and the number of cases of catheter slippage 24 h after catheter insertion.Method:A total of 128 children were randomly divided into the observation group and the control group.The catheter placement position of the control group was inserted at the most exposed part of blood vessels.In the observation group,the catheter was inserted 0.5 cm outside the most exposed part of the blood vessel,and the introducer sheath was inserted 0.5 cm subcutaneously and then inserted from above the blood vessel.The number of bleeding cases at the puncture point after catheter insertion,the distance of catheter migration,and the number of catheter sliding cases 24 h after catheter insertion were recorded respectively.Result:In the observation group,the number of bleeding cases was significantly less than that in the control group at 24 hours after catheterization,the difference was statistically significant(P<0.05).Catheter sliding of observation group was(1.196±0.460)mm,control group was(1.875±0.500)mm,there was a significant difference between the two groups(t=7.7204,P<0.01).The number of cases with catheter sliding≥5 mm in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Compared with the control group,the observation group of preterm infants with PICC catheter can effectively reduce the bleeding volume at the puncture point,effectively reduce the distance of catheter migration,and effectively reduce the number of cases of catheter slippage,thus reducing the occurrence of complications after PICC catheter insertion in preterm infants.