摘要
目的探究新生儿经上肢外周静脉置入中心静脉导管(PICC)穿刺术后导管尖端定位准确性的影响因素,提升导管使用的有效性,延长导管的使用时间,提高导管的使用价值。方法将2017年10月至2018年9月接受上肢PICC穿刺术的90例新生患儿纳入样本,其中36例穿刺术后导管尖端定位首次即定位准确(甲组),40例1次调管后导管尖端成功定位(乙组),14例进行2次调管定位(丙组)。分析穿刺术后导管尖端定位准确性的影响因素,根据影响因素进行调整,实施相应的护理干预措施,保持新生患儿体位稳定。结果单因素分析显示,甲组、乙组和丙组在穿刺部位、定位方法、体位状态方面,差异有统计学意义(P<0.05)。Logistic多因素回归分析显示,穿刺部位、定位方法、体位状态是新生儿经上肢PICC穿刺术后导管尖端定位准确性的影响因素。护理干预措施实施前,导管尖端定位首次即定位准确36例(40.00%),1次调管后导管尖端成功定位40例(44.44%),进行2次调管定位14例(15.56%);护理干预措施实施后,导管尖端定位首次即定位准确61例(67.78%),1次调管后导管尖端成功定位26例(28.89%),进行2次调管定位3例(3.33%),护理干预措施后,导管尖端定位首次即定位准确率高于护理干预措施实施前,1次调管后导管尖端成功定位率和进行2次调管定位率低于护理干预实施前,差异有统计学意义(P<0.05)。结论新生儿经上肢PICC穿刺术后导管尖端定位准确性的影响因素有穿刺部位、定位方法、体位状态等,护理干预可提升置管的准确性和稳定性。
Objective To investigate the influencing factors on the accuracy of catheter tip location after peripheral venous catheterization(PICC)puncture in upper limb of neonates,so as to improve the effectiveness of catheter use,prolong the use time of catheter and improve the value of catheter use.Methods Ninety neonates who underwent PICC puncture of upper limbs in our hospital from October 2017 to September 2018 were enrolled in the study,of whom,36 cases had accurate catheter tip localization for the first time after puncture(group A),and 40 cases had successful catheter tip localization after once catheterization(group B),and 14 caes had twice catheter tip localization(group C).The influencing factors of the accuracy of catheter tip positioning after puncture was analyzed to adjust the influencing factors and apply corresponding nursing intervention measures to keep the stabilization of position of neonates.Results The univariate analysis showed that there were significant differences in puncture site,location method and posture status among the three groups(P<0.05).Logistic multivariate regression analysis showed that puncture location,positioning method and posture status were the influencing factors for the accuracy of catheter tip positioning after PICC puncture in upper limbs of neonates.Before the implementation of nursing intervention measures,36 cases(40.00%)were positioned accurately for the first time,40 cases(44.44%)were successfully positioned after adjusting catheterization once and 14 cases(15.56%)were successfully positioned after adjusting catheterization twice.After the implementation of nursing intervention measures,61 cases(67.78%)were positioned accurately for the first time,26 cases(28.89%)were positioned successfully after adjusting catheterization once,and 3 cases(3.33%)were successfully positioned after adjusting catheterization twice.After nursing intervention,the accuracy of catheter tip positioning for the first time was higher than that before nursing intervention.The success rate of catheter tip positioning after adjusting catheterization once and the positioning rate of catheter tip after adjusting catheterization twice were significantly lower than those before nursing intervention(P<0.05).Conclusion The influencing factors for the accuracy of catheter tip positioning after PICC puncture in upper limbs of neonates are puncture location,positioning method and posture status,and nursing intervention can improve the accuracy and stability of catheterization.
作者
代洁
DAI Jie(The First People’s Hospital of Lianyungang City,Jiangsu,Lianyungang 222000,China)
出处
《河北医药》
CAS
2019年第19期3034-3036,3040,共4页
Hebei Medical Journal
