不同定位方法在新生儿PICC导管尖端位置中的对比研究

Comparative study of different positioning methods for PICC tips

目的研究不同定位方法在新生儿PICC导管尖端位置判断中的应用价值。方法选取2018年6月至2019年6月在本院出生的PICC置管新生儿90例,利用随机双盲法分为参照A组、参照B组和研究组,各30例。3组分别采用X线定位、超声定位和腔内心电图定位方法判断新生儿PICC导管尖端位置,对比3组的首次置管异位率、导管尖端定位操作时间以及置管相关并发症发生率。结果研究组和参照B组首次置管异位率均为6.67%,均低于参照A组的26.67%(P<0.05);研究组导管尖端定位操作时间(3.26±0.43)min短于参照A组的(14.93±2.02)min和参照B组的(5.31±0.62)min(P<0.05);研究组置管相关并发症发生率为3.33%,低于参照A组的26.67%和参照B组的23.33%(P<0.05)。结论在新生儿PICC导管尖端位置判断中,采用腔内心电图定位方法和超声定位方法,均可降低首次置管异位率,但腔内心电图定位方法的定位操作时间更短,置管相关并发症发生率更低,值得临床推广。

Objective To study the application value of different positioning methods for PICC tips. Methods 90 newborns underwent PICC were selected in our hospital from June 2018 to June 2019 and divided into reference group A, reference group B and study group according to double-blind method, with 30 cases in each group. During PICC tip positioning process, three groups adopted X-ray examination, ultrasonography and electrocardiogram, respectively. The initial indwelling displacement rate, positioning time and catheter-associated complication rate were compared among three groups. Results The initial indwelling displacement rate in study group and reference group B was 6.67%, and significantly lower than reference group A(26.67%)(P<0.05). The positioning time in the study group was(3.26±0.43) min, which was significantly shorter than reference group A and reference group B [(14.93 ± 2.02) min vs.(5.31 ± 0.62) min](P<0.05). The catheter-associated complication rate in the study group(3.33%) was significantly lower than reference group A(26.67%) and reference group B(23.33%)(P<0.05). Conclusion Both of electrocardiogram and ultrasonography can reduce the initial indwelling displacement rate. However, electrocardiogram can shorten the positioning time and reduce the catheter-associated complications. It is worthy of application in clinical practice.