脐静脉置管的导管留置时间对早产儿的影响分析

Effect of Catheten Indwelling Time on Preterm Infant

目的探讨脐静脉置管的导管留置时间对早产儿并发症的影响,并分析并发症的危险因素。方法选取2015年1月至2018年12月南宁市第一人民医院新生儿科行脐静脉置管术的286例早产儿作为研究对象,按导管留置时间分为≤10 d组(n=149)和>10 d组(n=137),比较两组患儿导管留置时间对并发症的影响及并发症的危险因素分析。结果>10 d组导管相关性感染高于≤10 d组(P<0.05);在≤10 d组置管后腹胀发生率高于>10 d组(P<0.05);两组患儿非红系细胞百分比(NEC)、脐出血、心律失常、血栓或堵管、置管后导管移位发生率比较差异无统计学意义(P>0.05)。两组患儿发生并发症的危险因素分析:①导管留置时间在导管相关性感染、无导管相关性感染中比较差异有统计学意义(P<0.05)。②导管位置、导管留置时间在置管后腹胀、置管后无腹胀中比较差异有统计学意义(P<0.05),应用Logistic多因素回归分析结果显示,低位脐静脉置管发生腹胀的概率是标准脐静脉置管的4.013倍。结论脐静脉置管留置时间延长,可增加导管相关性感染的风险,而标准脐静脉置管术后发生腹胀的概率较低。

Objective To investigate the effect of catheter indwelling time on complications of UVC,and analyze the risk factors of complications.Methods Totally 286 cases of preterm infants dealt with umbilical vein catheterization in the First Affiliated Hospital of Guangxi Medical University between January 2015 and December 2018 were received.According to the catheter indwining time,the children were divided into the≤10 days group(n=149)and the>10 days group(n=137).The infLuence of catheter indwining time on complications and risk factors of complications were compared between the two groups.Results Catheter-related infection in the>10 days group was higher than that in the≤10 days group(P<0.05),and abdominal distension in the≤10 days group was higher than that in the>10 days group(P<0.05).NEC,umbilical hemorrhage,arrhythmia,thrombosis or occlusion,and catheter displacement were no statistical difference between the two groups(P>0.05).Analyze the risk factors of complications in the two groups:①The catheter indwelling time in catheter-related infection and no catheter-related infection was significant difference(P<0.05).②The catheter position,the indwelling time in abdominal distension and no abdominal distension after catheterization were significant differences(P<0.05).By logistic multiple regression analysis,low umbilical vein catheter incidenced abdominal distension,which was 4.013 times that of the standard umbilical vein catheter.Conclusion Prolonged indwelling of umbilical vein catheter increases the risk of catheter-related infection.The standard umbilical vein catheter has less probability of abdominal distension after catheterization.