新生儿经不同部位置入PICC的对比研究.docVIP

新生儿经不同部位置入PICC的对比研究 　　【摘要】 目的：研究在新生儿的不同部位置入PICC的效果。方法：收集需要置入PICC导管的新生儿共92例，分为50例对照组和42例观察组，对照组患儿经肘部静脉置入PICC导管，观察组经头部颞浅静脉将PICC导管置入，将两组患儿一次性血管穿刺成功率、置管障碍率、静脉炎发生率进行观察和对比。结果：观察组患儿的一次性血管穿刺成功率明显高于对照组，观察组患儿的置管障碍率显著低于对照组患儿，观察组患儿的静脉炎发生率显著低于对照组患儿，观察组患儿的渗血量显著少于对照组，差异均有统计学意义（P中国论文网 /6/view-7251096.htm 　　【关键词】 新生儿； PICC置管； 不同部位； 对比研究 　　中图分类号 R47 文献标识码 B 文章编号 1674-6805（2016）4-0092-02 　　A Comparative Study of PICC in Different Parts of Neonate/WU Hong-rong.//Chinese and Foreign Medical Research，2016，14（4）：92-93 　　【Abstract】 Objective：To study the effect of PICC in different parts of the neonate.Method：A total of 92 neonates with PICC catheter were collected，and divided into 50 cases in the control group and 42 cases in the observation group.The control group was implanted with PICC catheter from the basilica vein.The observation group was placed PICC catheter from the the head vein.The success rate of one-time puncture，the rate of catheterization，the incidence of phlebitis were observed and compared.Result：The observation group with disposable blood vessel one-time puncture success rate was significantly higher than that of the control group，the observation group with catheter disorder rate was significantly lower than that of the patients in the control group，the observation group with phlebitis incidence was significantly lower than that of the control group，the patients in the observation groups with bleeding was significantly less than the control group，the differences were all significant（P0.05），有可比性。所有新生儿家属均签署了研究知情同意书。 　　1.2 方法 　　对照组患儿经肘部静脉置入PICC导管，患儿取仰卧位，双上肢展平与身体纵轴呈90°角，对置管长度进行测量，注意从穿刺点到胸锁关节处应额外加长0.5～1.0 cm[3]。对患儿穿刺侧的手掌、手指、手臂、肩胛以及腋窝进行消毒和铺巾，在静脉穿刺中见到回血后立即送针并撤回针芯，把导管缓慢地轻柔地送入并达到测量的长度。 　　观察组经头部颞浅静脉将PICC导管置入，患儿的头皮毛发剃除后将头部偏向穿刺的对侧并对置管的长度进行测量，从穿刺点沿着静脉经耳部到颈部，转向右胸锁的关节处直到第二肋间。局部消毒、铺巾，在静脉穿刺中见到回血后立即送针并撤回针芯，把导管缓慢地轻柔地送入，当导管的送入长度为4～5 cm时，拉伸患儿的颈部并将患儿的同侧手臂上举；当导管的送入长度为8～10 cm时，让患儿侧卧并继续送管到预定的长度。 　　1.3 评价指标 　　将对照组和观察组新生儿的一次性血管穿刺成功率、置管障碍率、渗血量、静脉炎发生率进行统计和对比。 　　1.4 统计学处理 　　研究中所得数据使用统计学软件S