摘要
目的极低出生体质量新生儿常需要较长时间的静脉营养来保证其正常生长发育,为了寻找加强静脉营养管理效果的方法,本研究探讨改良脐静脉置管联合外周中心静脉置管(peripherally inserted central catheter,PICC)在极低出生体质量新生儿中的应用效果。方法选取2015年3月—2017年2月衢州市妇幼保健院重症监护室极低出生体质量新生儿48例作为研究对象,所有新生儿均给予脐静脉置管联合PICC,其中行传统脐静脉置管新生儿作为对照组(28例),行改良脐静脉置管新生儿作为观察组(20例)。观察2组新生儿脐静脉置管时间、脐出血、脱垂发生情况,PICC留置时间、一次穿刺成功、计划性拔管情况,以及达到全胃肠内营养时间、住院时间。结果观察组新生儿脐静脉置管时间明显高于对照组(P<0.05),但2组脐出血发生率、脱垂发生率差异无统计学意义(均P>0.05);观察组PICC置管时间明显高于对照组(P<0.05),但2组一次穿刺成功率、计划性拔管率差异无统计学意义(均P>0.05);观察组达到全胃肠内营养时间、住院时间均明显少于对照组(均P<0.05)。结论对极低出生体质量新生儿应用改良脐静脉置管联合PICC,可明显延长置管时间,减少不良事件的发生,缩短达到全胃肠内营养时间及住院时间。
Objective The infants with extremely low birth weight often require a longer period of intravenous nutrition to ensure their normal growth and development. The aim of this paper is to observe the effect of improved umbilical vein catheterization combined with PICC in the intravenous nutrition management of infants with extremely low birth weight. Methods A total of 48 infants with extremely low birth weight were divided into control group （28 cases） and observation group （20 cases） from March, 2015 to February, 2017. The infants of the control group received traditional umbilical vein catheter and PICC, while the infants of the observation group received the improved umbilical vein catheterization and PICC. The umbilical vein catheter indwelling time, incidence of umbilical bleeding, incidence of accidental catheter detachment, PICC indwelling time, rate of once puncture success, incidence of planned extubation, time to total gastroin- testinal nutrition and hospital stay were observed. Results Umbilical vein catheter indwelling time of the observation group was significantly longer than that in the control group （ P 〈 0.05 ）, the incidence of umbilical bleeding and acciden- tal catheter detachment had no significant difference between the two groups （ P 〉 0.05 ） ; PICC indwelling time of the observation group was significantly longer than that in the control group （ P 〈 0.05 ） , and incidence of once puncture success and planned extubation had no significant difference between the two groups （ P 〉 0.05 ） ; The time to total gastrointestinal nutrition and hospital stay of the observation group was significantly lower than those in the control group （ P 〈 0.05）. Conclusion The improved umbilical vein catheterization combined with PICC can markedly prolong indwelling time, reduce the occurrence of adverse events, and shorten the time to whole gastrointestinal nutrition and hospital stay in infants with extremely low birth weight.
作者
刘澄之
周雄英
俞君
汪月华
张志群
LIU Cheng-zhi;ZHOU Xiong-ying;YU Jun;et al(Department of Pediatrics, Quzhou City Maternity and Child Care Hospital, Quzhou, Zhejiang 324000, Chin)
出处
《中华全科医学》
2018年第1期83-85,共3页
Chinese Journal of General Practice
基金
2014年浙江省医药卫生科技计划项目(2014RCA-021)
浙江省衢州市科技局2014年度指导性科技项目(2014138)
关键词
改良脐静脉置管
外周中心静脉置管
极低出生体质量
新生儿
Improved umbilical vein catheterization
Peripherally inserted central catheter
Extremely low birth weight
Infants
