早产儿经不同外周静脉置入中心静脉导管的效果分析

Effect Analysis of Different Peripherally Inserted Central Catheters in Premature Infants

目的:探讨早产儿经不同外周静脉置入中心静脉导管的效果。方法:选取2020年7月—2022年6月于玉林市第一人民医院行经外周静脉置入中心静脉导管(PICC)的早产儿90例作为研究对象,随机分为上肢静脉组、下肢静脉组及头部静脉组,各30例。上肢静脉组、下肢静脉组及头部静脉组均行PICC,位置分别为上肢静脉、下肢静脉、头部静脉。比较三组置管效果。结果:下肢静脉组PICC置管疼痛评分低于上肢静脉组、头部静脉组,差异有统计学意义(P<0.05)。三组并发症总发生率比较,差异无统计学意义(P=0.383)。三组血红蛋白、血小板计数、血细胞比容水平比较,差异无统计学意义(P>0.05)。下肢静脉组直接胆红素、总胆红素、总胆汁酸、谷氨酰转移酶水平低于上肢静脉组、头部静脉组,差异有统计学意义(P<0.05)。结论:相较于上肢、头部静脉PICC置管,下肢静脉PICC置管能够减轻早产儿置管疼痛感,减少胆汁淤积风险,且不会增加不良反应。

Objective:To explore the effects of different peripherally inserted central catheters in premature infants.Methods:A total of 90 premature infants who underwent peripherally inserted central catheter(PICC)in the First People's Hospital of Yulin from July 2020 to June 2022 were selected as the study subjects.They were randomly divided into upper limb vein group,lower limb vein group and cephalic vein group,with 30 cases in each group.PICC was performed in upper limb vein group,lower limb vein group and cephalic vein group,and the catheter was placed in upper limb vein,lower limb vein and cephalic vein,respectively.The effect of catheterization was compared among three groups.Results:The pain score of PICC catheterization in the lower limb vein group was lower than that in the upper limb vein group and the cephalic vein group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of complications among three groups(P=0.383).There was no significant difference in hemoglobin,platelet count and hematocrit among three groups(P>0.05).The levels of direct bilirubin,total bilirubin,total bile acids and glutamyl transferase in the lower limb vein group were lower than those in the upper limb vein group and the cephalic vein group,and the difference was statistically significant(P<0.05).Conclusion:Compared with upper limb and cephalic venous PICC catheterization,lower limb venous PICC catheterization can reduce the pain of catheterization in preterm infants,reduce the risk of cholestasis,and will not increase adverse reactions.