1例24周超早产儿PICC胸腔渗液原因分析及护理对策

Causal analysis and measures of chest exudation of PICC catheter in a 24-week extremely preterm infant

总结1例24周超早产儿(extremely preterm infant,EPI)经外周静脉穿刺中心静脉导管(peripherally inserted central catheter,PICC)后胸腔渗液原因及护理对策。我科于2022年2月收治1例EPI,留置PICC后第32天突发经皮血氧饱和度及心率下降,皮肤颜色呈灰白色,胸廓运动不明显,急查床旁X线胸片示右侧大量胸腔积液,PICC导管尖端位置由T_(4)~T_(5)上移至T_(1)~T_(2),经胸腔穿刺抽液、拔除PICC导管处理,并予营养支持及系列精心护理。经过102 d的治疗护理,患儿康复出院。EPI因PICC置管致胸腔渗液后应及时分析原因并进行总结,并探讨相应的护理措施及预防方案。

Objective To summary the cause and care measures of chest exudation of peripherally inserted central catheter(PICC)catheter through the right precious vein in a 24-week extremely preterm infant(EPI).One 24-week extremely premature infant was placed with a PICC catheter through the right precious vein on the 32 nd day,sudden percutaneous oxygen saturation and heart rate decreased,the skin color was gray-white,the thoracic movement was not obvious,and the emergency bedside X-ray chest x-ray showed a large pleural effusion on the right side,the tip of the PICC catheter was moved up from T_(4)-T_(5)to T_(1)-T_(2),and the PICC catheter was removed through the chest puncture,and rehabilitation and discharge after nutritional support and careful care.The child was discharged from hospital after 102 d.The causes of pleural effusion induced by PICC catheter in EPI should be analyzed in a timely manner and summarized,and the corresponding nursing measures and preventive plan should be discussed.