摘要
目的 探讨新生儿PICC导管相关性静脉炎的发生情况和危险因素,为预防静脉炎的发生提供护理参照.方法 2015年9月—2017年2月对深圳市7家医院594例留置PICC导管的新生儿开展前瞻性研究,观察静脉炎的发生情况,对影响静脉炎发生的相关因素进行多因素非条件Logistic回归分析.结果 594例留置PICC导管的新生儿中,共68例发生了静脉炎,导管相关性静脉炎的发生率11.45% （4.56/1000导管日）.单因素分析结果显示出生体质量、置管时体质量、置管前是否浸泡导管、置管静脉、导管末端位置是否异位差异有统计学意义（P〈0.05）.多因素分析显示导管末端异位、置管时体质量、置管前有否0.9%氯化钠溶液浸泡导管是独立影响因素（P〈0.05）,其中导管末端异位是危险因素（OR=2.295,95%CI=1.054~4.999）,置管时体质量（OR=0.999,95%CI=0.999~1.000）、置管前0.9%氯化钠溶液浸泡导管（OR=0.379,95%CI=0.190~0.755）是保护因素.结论 建议新生儿PICC置管前用0.9%氯化钠溶液浸泡导管、置管时尽量避免导管异位以降低静脉炎发生的风险,对置管时体质量越低的新生儿越应注意动作轻柔,减少对血管的损伤.
Objective To explore the incidence and risk factors of peripherally inserted central catheter （PICC） related phlebitis in neonate, so as to provide references for phlebitis prevention. Methods Between September 2015 and February 2017, a prospective study on 594 neonates from 7 hospitals of Shenzhen City was conducted. The study focused on the incidence of phlebitis, and non-conditional multivariable logistic regression analysis was applied to determine independent predictors of PICC related phlebitis in neonate. Results There were 68 cases of phlebitis in 594 neonates with PICC, with the incidence rate of PICC related phlebitis 11.45% （4.56/1 000 catheter days）. The result of single factor analysis showed that the difference of phlebitis incidence was statistical significant in patients with different weight at birth, different weight on the puncture day, whether catheter immersed in normal saline before insertion, different vein of insertion and catheter tip malposition （P〈0.05）. Multivariated Logistic regression analysis showed that catheter tip malposition, weight on the puncture day and whether catheter immersed in normal saline before insertion were independent influencing factors （P〈 0.05）. Among these factors, catheter tip malposition was the risk factor （OR=2.295, 95%CI=1.054-4.999）; weight on puncture day （OR=0.999, 95%CI=0.999-1.000） and whether catheter immersed in normal saline before insertion （OR=0.379, 95%CI=0.190-0.755） were protective factors. Conclusions It is suggested that to immerse catheter in normal saline before insertion and to avoid catheter tip malposition can decrease the risk of PICC related phlebitis in neonate. It is also advised to pay more attention to those whose weight was low on the puncture day, so as to decrease the damage to vessels.
出处
《中华现代护理杂志》
2018年第10期1164-1169,共6页
Chinese Journal of Modern Nursing
基金
深圳市科创委资助项目（JCYJ20150403101146319）
关键词
导管插入术
外周
婴儿
新生
静脉炎
危险因素
Catheterization
peripheral
Infant
newborn
Phlebitis
Risk factors
