经胸壁B超定位法在新生儿PICC置管中的应用效果

Application of transthoracic B-ultrasound positioning in neonatal PICC catheterization

目的探讨经胸壁B超定位法在新生儿经外周静脉中心静脉置管(PICC)中的应用效果。方法选取2018年6月~2019年5月于广东省揭阳市人民医院新生儿科进行PICC置管治疗的66例新生儿,采用随机数字表法将其分为试验组(33例)和对照组(33例)。对照组常规穿刺置管后,X线拍片定位尖端位置;试验组经胸壁B超定位后,进行常规穿刺置管,X线拍片定位尖端位置。比较两组的置管操作时间、置管完成效果及并发症。结果试验组PICC置管操作时间短于对照组,差异有统计学意义(P<0.05);试验组的PICC置管完成效果优于对照组,差异有统计学意义(P<0.05);试验组的PICC置管后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论经胸壁B超定位法在新生儿PICC置管尖端位置方法准确性高,能节约置管定位时间;并且其并发症发生率低,安全性较强。

Objective To explore the effect of early transthoracic wall ultrasonography in neonatal peripherally inserted central catheter(PICC)catheterization.Methods A total of 66 neonates who underwent PICC catheterization in Jieyang People′s Hospital of Guangdong Province from June 2018 to May 2019 were enrolled.According to the random number table method,they were divided into experimental group(33 cases)and control group(33 cases).After the conventional puncture was placed in the control group,the X-ray film was positioned at the tip position;after the B-ultrasound of the chest wall was placed in the experimental group,the conventional puncture was performed,and the X-ray film was positioned at the tip position.The catheterization time,catheterization completion and complications were compared between the two groups.Results The operation time of PICC in the experimental group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The PICC catheterization in the experimental group was better than the control group,and the difference was statistically significant(P<0.05).The incidence of complications after PICC catheterization was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The application of B-ultrasound positioning in the chest wall is effective in the placement of neonatal PICC,and its complication rate is lower but the safety is stronger.