意外伤害患儿上腔静脉置入20cm中长导管的效果观察

Effect of Inserting 20cm Midline Catheter into Superior Vena Cava in Children with Accidental Injury

目的探讨1~3周岁意外伤害患儿上腔静脉置入20 cm中长导管的应用效果。方法选取某三级甲等医院1~3周岁意外伤害患儿为研究对象,2016年1月—2017年12月置入PICC意外伤害患儿为对照组,2018年1月—2019年10月采用20 cm中长导管置管的意外伤害患儿为观察组。对照组采用PICC导管,观察组采用20 cm中长导管,比较2组意外伤害患儿置管总费用、导管末端位置准确率、导管留置时间、置管后并发症发生率。结果20 cm中长导管置入上腔静脉费用(752元)较PICC导管费用(1953元)低;2组患儿导管末端到达理想位置(上腔静脉下1/3)情况比较,差异无统计学意义(P>0.05);2组患儿导管留置时间和并发症发生率比较,差异无统计学意义(P>0.05)。结论20 cm中长导管置入上腔静脉能够为1~3周岁意外伤害患儿提供安全、有效的静脉输液通路,同时较PICC置管相比,可降低患儿的置管费用,置入上腔静脉达理想位置与PICC导管相同,其留置时间与PICC导管相当,满足患儿治疗需要,不增加并发症发生,安全可行,值得临床借鉴使用。

Objective To investigate the efficacy of 20cm midline catheter placement in superior vena cava in toddlers with unintentional injury.Methods Cases of toddlers with unintentional injury and received peripherally inserted central catheter(PICC)from January 2016 to December 2017 in a tertiary grade-A hospital were taken as control group and those who received 20 cm midline catheter from January 2018 to October 2019 were selected as intervention group.The control group was treated with traditional PICC catheterization,and the intervention group with a 20cm midline catheter into the superior vena cava.Then the total cost of catheterization,the accuracy of catheter end position,catheter indwelling time,and the incidence of complications after catheterization were compared between the two groups.Result The cost of 20cm midline catheterization of superior vena cava(752 yuan)was lower than that of PICC catheterization(1,953 yuan).There was no significant difference between the two groups when the end of the catheter reached the ideal position(1/3 of the superior vena cava)(P>0.05).There was no significant difference in catheter indwelling time and complication rate between the two groups(P>0.05).Conclusion The insertion of 20cm midline catheter into the superior vena cava can provide safe and effective intravenous infusion access for toddler with unintentional injury.Compared with PICC catheterization,it can significantly reduce the catheterization cost,and it is worthy of further promotion in clinical practice.