摘要
目的研究心房内心电图引导新生儿经外周静脉置入中心静脉导管(PICC)尖端定位方法的临床应用。方法2019年5月—2020年5月,新疆维吾尔自治区人民医院新生儿科行PICC置管儿200例,将其设定为研究组。2019年以前置过PICC的患儿200例,将其设定为对照组。研究组运用心房内心电图引导PICC尖端定位方法,然后对新生儿进行胸部X线透视检查,对PICC导管尖端位置进行双重确认;对照组运用体表定位方法,确定导管拟到达长度后,对新生儿进行胸部X线透视检查,将导管尖端位置确定下来。统计分析两组新生儿的置管成功情况、敏感度、特异度、PICC尖端位置、操作使用时间、置管成本、PICC置管术后并发症发生情况及家长满意度。结果研究组新生儿的置管成功率、敏感度均显著高于对照组,特异度显著低于对照组(P<0.05)。PICC尖端位置位于上腔静脉、上腔静脉下段及其和右心房交界的比例均显著高于对照组(P<0.05)。研究组新生儿的操作使用时间显著短于对照组,置管成本低于对照组(P<0.05)。研究组新生儿的PICC置管术后并发症发生率(6.5%)显著低于对照组(20.0%)(P<0.05)。研究组新生儿家长满意度(98.0%)显著高于对照组(79.0%)(P<0.05)。结论心房内心电图引导新生儿PICC尖端定位方法的临床应用效果较体表定位方法好,值得推广。
Objective To study the clinical application of tip localization of central venous catheter(PICC)guided by atrial electrocardiogram in newborns.Methods From May 2019 to May 2020,200 infants with PICC were selected as the study group.In 2019,200 children with pre PICC were selected as the control group.The study group used atrial endocardiogram to guide the PICC tip positioning method and then carried out chest X-ray fluoroscopy on the newborn to double confirm the PICC catheter tip position.The control group used body surface positioning method to determine the length of the catheter to be reached and carried out chest X-ray fluoroscopy on the newborn to determine the catheter tip position.Then the success,sensitivity,specificity,PICC tip position,operation time,cost,complications and parents’satisfaction of the two groups were statistically analyzed.Results The success rate and sensitivity of neonatal catheterization in the study group were significantly higher than those in the control group,and the specificity was significantly lower than that in the control group(P<0.05).The proportion of PICC tip in superior vena cava,inferior segment of superior vena cava and its junction with right atrium was significantly higher than that in the control group(P<0.05).The operation and use time of newborns in the study group was significantly shorter than that in the control group,and the cost of catheterization was lower than that in the control group(P<0.05).The incidence of complications after PICC catheterization in the study group(6.5%)was significantly lower than that in the control group 20.0%(P<0.05).The parental satisfaction of newborns in the study group 98.0%was significantly higher than that in the control group 79.0%(P<0.05).Conclusion The clinical efficacy of PICC tip localization is guided by atrial endocardiogram and is better than that of body surface localization.
作者
杨丽娟
任燕
YANG Lijuan;REN Yan(Department of Neonatology,Children's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China;Department of Neonatology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830000,China)
出处
《新疆医科大学学报》
CAS
2021年第12期1417-1421,共5页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区自然科学基金(2019D01C143)。
关键词
新生儿
PICC尖端定位方法
心房内心电图引导
体表定位
newborn
PICC tip positioning method
atrial electrocardiogram guidance
body surface positioning
