经腋静脉穿刺置入PICC在极低出生体质量儿中的应用被引量：12

The application effect of PICC through axillary vein puncture in very low birth weight infants

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摘要目的:探讨极低出生体质量儿不同穿刺部位置入外周穿刺中心静脉导管(peripherally inserted central catheters,PICC)的应用效果。方法:将符合PICC指征的90例极低出生体质量儿随机分为观察组和对照组,各45例。对照组经肘部静脉穿刺置入PICC,观察组经腋静脉穿刺置入PICC,其余护理方法相同。比较2组的穿刺时间、送管时间、导管尖端正位率、留置时间、导管相关并发症等方面差异。结果:观察组的穿刺时间(1 229.16±209.63)s,送管时间(51.35±126.38)s,导管尖端正位率86.67%,留置时间(24.16±11.81)d,PICC堵管7例,导管尖端培养阳性率12.00%,脱管1例;对照组的穿刺时间(1 447.31±426.70)s,送管时间(95.71±115.41)s,导管尖端正位率86.67%,留置时间(23.76±15.41)d,静脉炎3例,PICC堵管8例,导管尖端培养阳性率21.74%。观察组的穿刺时间少于对照组(P<0.01);2组送管时间、导管尖端正位率、留置时间、导管相关并发症等方面差异均无统计学意义(P>0.05)结论:对于极低出生体质量儿,除肘部静脉外,在条件允许情况下,可以将腋静脉作为PICC穿刺部位。 Objective ：To explore the application effects of peripherally inserted central catheter（PICC） via the axillary vein in very low birth weight infants. Methods： Ninety very low birth weight infants were randomly divided into the observation group and control group（45 cases each group）. The observation group and control group were treated with PICC via axillary vein and PICC via elbow vein, respectively. The puncture time, tube feeding time, catheter tip positive rate, retention time and catheter related complications between two groups were compared. Results：The puncture time, tube feeding time, catheter tip positive rate and retention time in observation group were （ 1 229.16 ± 209.63 ） s, （ 51.35 ± 126.38 ） s, 86.67 % and （ 24.16 ± 11.81 ） d, respectively. The PICC plugging in 7 cases, 12.00% of catheter tip culture positive rate and tube detachment in 1 case were found in observation group. The puncture time, tube feeding time, catheter tip positive rate and retention time in control group were （1 447.31 ± 426.70）s, （95.71 ± 115.41 ）s, 86.67% and （23.76 ± 15.41 ） d,respectively. The phlebitis in 3 cases,PICC plugging in 8 cases and 21.74% % of catheter tip culture positive rate were found in control group. The puncture time in observation group was less than that in control group（ P 〈 0. 01 ）. The differences of tube feeding time, catheter tip positive rate, retention time and catheter related complications between two groups were not statistically significant（P 〉0.05）. Conclusions ：In addition to the elbow vein,the axillary vein can also be used as the PICC puncture site in very low birth weight infants.