新生儿外周静脉留置针穿刺侧体位管理辅助装置的设计与应用效果

Effect of a self-designed auxiliary device for lateral position management of neonatal peripheral venous indwelling needle puncture

目的为了减少新生儿静脉留置针穿刺相关并发症的发生,本研究拟设计一种新生儿外周静脉留置针穿刺侧体位管理辅助装置并探究其在新生儿重症监护室(NICU)的应用效果。方法将患儿随机分为研究组和对照组各132例,再按照早产儿和足月儿对两组进行分组比较。研究组患儿静脉留置针穿刺后立即采用该装置对穿刺侧肢体进行体位调整;对照组132例患儿同样的密切观察,但不施加特殊体位干预。分别比较两组患儿使用该装置过程中的静脉导管留置时间、并发症及相关不良事件等。结果对于足月儿,两组穿刺点渗血、静脉炎、敷料松脱、输液不畅、导管留置时间差异均有统计学意义(P<0.05);对于早产儿,两组穿刺点渗血、静脉炎、因关节屈曲导致输液不畅、导管留置时间差异也均有统计学意义(P<0.05),两组早产儿敷料松脱情况比较差异无统计学意义(P>0.05),两组患儿在研究期间除静脉炎外均未发生相关不良事件。结论通过关节伸展带装置辅助新生儿静脉置管后的体位管理,既实现了体位的调整,又完成了关节的固定与调节,为患儿的生命线提供了多重保障。

Objective To design an auxiliary device for lateral position management of neonatal peripheral venous indwelling needle puncture and examine its effect on occurrence of complications in NICU infants.Methods One hundred and thirty-two newborns were randomly assigned as the study group and another 132 newborns as the control group,the two groups compared in regard to premature and term newborns.In the study group,the self-designed device was used to adjust the position of the limb on the side of the puncture immediately after the venous indwelling needle puncture,and in the control group no position adjustment was done.The duration of venous catheter indwelling,the complications and related adverse events were compared.Results There were significant differences in oozing at the puncture point,phlebitis,dressing loose,poor infusion and catheter indwelling duration between the term newborns of the two groups(P<0.05),while between the premature neonates of the two groups,there were significant differences in oozing at the puncture point,phlebitis,poor infusion due to joint flexion,and catheter indwelling duration(P<0.05).There was no significant difference in dressing loosening between the two groups(P>0.05).No adverse events except phlebitis occurred in both groups.Conclusion The device with joint extension belt designed for assisting the postural management of neonates after intravenous catheterization is good for the posture adjustment as well as for the fixation and adjustment of the joints,which provides multiple safety guarantees for the neonates.