早产儿经上肢与下肢置入经外周置入中心静脉导管效果对比

Effect comparison of peripherally inserted central venous catheter through upper and lower limbs in premature infants

目的探究早产儿经上肢与下肢置入经外周置入中心静脉导管(PICC)效果差异。方法筛选2020年5月至2021年4月惠州市第三人民医院收治的96例PICC置入早产儿,应用随机数字表法将其分为观察组(下肢静脉穿刺)和对照组(上肢静脉穿刺),每组各48例,比较两组置管效果。结果与对照组比较,观察组置管操作时间更短、出血量更少,且PICC留置时间更长;观察组送管困难率、导管异位率分别为4.17%、2.08%,低于对照组的16.67%、14.58%,观察组一次穿刺成功率(97.92%)高于对照组(83.33%);观察组并发症发生率(6.25%)低于对照组(20.83%);穿刺置管时,两组患儿心率明显加快,但观察组穿刺置管时、穿刺置管即刻、置管后5 min、置管后15 min心率水平低于对照组,差异均有统计学意义(P<0.05)。结论对于PICC置管早产儿,选择下肢静脉进行穿刺置管优势显著。

Objective To explore the effect of peripherally inserted central venous catheter(PICC)through upper and lower limbs in premature infants.Methods A total of 96 premature infants with PICC implantation admitted to the Third People’s Hospital of Huizhou from May 2020 to April 2021 were screened and divided into observation group(lower limb venipuncture)and control group(upper limb venipuncture)by random number table method,48 cases in each group,and the catheterization effect was compared between the two groups.Results Compared with the control group,the operation time of catheterization in the observation group was shorter,the amount of blood loss was less,and the indwelling time of PICC was longer.The difficulty rate of catheterization and ectopic rate of catheterization in the observation group were 4.17%and 2.08%,respectively,lower than 16.67%and 14.58%of the control group.The success rate of one puncture in the observation group(97.92%)was higher than that in the control group(83.33%).The incidence of complications in the observation group(6.25%)was lower than that in the control group(20.83%).The heart rate of the two groups was significantly increased during catheterization,but the heart rate in the observation group was lower than that in the control group during catheterization,immediately after catheterization,5 min after catheterization,and 15 min after catheterization,the difference were statistically significant(P<0.05).Conclusion For premature infants with PICC catheterization,the choice of lower limb vein catheterization has significant advantages.