低出生体重早产儿经外周静脉穿刺置入中心静脉导管异位的影响因素分析

Analysis of Influencing Factors on Ectopic Peripherally of Inserted Central Venous Catheterization for Low Birth Weight Premature Infants

目的:探讨低出生体重早产儿(LBW-PI)经外周静脉穿刺置入中心静脉导管(PICC)发生置管异位影响因素.方法:选取2020年1月至2023年7月本院拟行PICC置管的LBW-PI 96例为研究对象.根据是否发生置管异位,将其分别纳入研究组(n=24,PICC发生异位者)和对照组(n=72,PICC无异位者).收集患儿的临床资料,分析LBW-PI PICC异位发生的影响因素.结果:LBW-PI的PICC异位率为25.00%(24/96).多因素非条件Logistic回归分析结果显示,出生胎龄<32周、出生时体重<1500g、置管前机械通气、左上肢置管、置管时日龄1d、置管护士层级、贵要静脉置管、头静脉置管均为导致LBW-PI发生PICC异位的独立影响因素(OR>1,P<0.05).结论:LBW-PI的PICC异位率高,可能与早产儿出生胎龄、出生时体重、置管前机械通气、置管时日龄、左上肢置管、置管护士层级、头静脉和贵要静脉等有关.

Objective:To explore influencing factors of catheter heterotopia in low birth weight premature infants with peripherally inserted central venous catheterization(PICC).Methods:A total of 96 cases of low birth weight premature infants(LBW-PI)who were scheduled to undergo PICC in our hospital from January 2020 to July 2023 were selected as research subjects in this study.According to whether ectopic catheterization occurred,they were divided into research group(n=24,PICC ectopic)and control group(n=72,the non ectopic catheterization).The clinical data of pediatric patients were collected and the influencing factors of ectopic PICC in low birth weight premature infants were analyzed.Results:The incidence of ectopic PICC catheterization was 25.00%(24/96)in low birth weight premature infants.By multivariate unconditional logistic regression analysis,gestational age<32 weeks,birth weight<1500g,mechanical ventilation before catheterization,left upper limb catheterization,age 1d at catheterization,nurse level of PICC catheterization,basilic vein catheterization,cephalic vein catheterization were the influencing factors of PICC catheterization heterotopia in low birth weight premature infants(OR>1,P<0.05).Conclusion:Low birth weight premature infants are prone to ectopic PICC catheterization,which may be related to gestational age,birth weight,mechanical ventilation before catheterization,catheterization age,left upper limb catheterization,catheterization nurse level,basilic vein catheterization,cephalic vein catheterization.