套管针在早产低体重儿静脉营养中的应用

Use of Indwelling Catheterization for Intravenous Nutrition in Preterm Low Birth Weight Infants

目的 探讨应用套管针在早产低体重儿(PLBW)实行静脉营养时的方法及优点。方法 将47例实行静脉营养的PLBW分为2组,观察组:22例采用全封闭式Y型套管针。对照组:25例采用头皮针。观察比较每次静脉通道维持的时间和输液局部的反应情况。结果 (1)静脉通道维持时间:观察组为29.3±8.1 h,对照组为18.0±8.0h(P<0.001);两组局部肿渗情况:(2)观察组局部出现硬结较对照组少(P<0.001);(3)针管内有回血:观察组较对照组多(P<0.001);(4)局部皮肤颜色的改变:观察组少于对照组(P<0.001)。结论 在早产低体重儿实施外周静脉营养时使用全封闭式Y型套管针,能减少小静脉穿刺的局部反应,确保治疗顺利进行,且操作简便。因此,PLBW周围静脉营养途径的选择应首选套管针,其次为头皮针,临床上两者可结合使用。

Objective To discuss the use and merits of indwelling catheterization for intravenous nutrition in preterm low birth weight infants. Methods 47 preterm low birth weight infants were divided into two groups: the study group (n=22), who were infused by the Y-type indwelling catheter via the peripheral vein, and the control group (n=25), who were fed via the cephalic vein. Duration of catheter patency and local reactions of the two groups were observed and compared. Results The time of catheter patency was 29.3±8.1h for the study group and 18.0±8.0h for the control group, the difference being significant (P<0.001). The study group had lower incidence of sclerosis at the injection sites, more syringe blood reflux and lower incidence of local skin discoloration as compared with the control group (P<0.001). Conclusion Y-type indwelling catheterization is the treatment of choice for intravenous nutrition of preterm low birth weight infants due to simplicity of operation and fewer local reactions. The alternative is cephalic venous catheterization. In practice, they can be used in combination.