70例新生儿脐静脉置管术异位的临床分析.docVIP

70例新生儿脐静脉置管术异位的临床分析 　　[摘要] 目的 探讨新生儿脐静脉置管术的异位情况及解决办法。 方法 对186例新生儿实施UVC的异位情况进行回顾性分析，分析相关UVC异位发生原因及可能解决办法。 结果 186例新生儿实施UVC术，发生异位70例，其中过浅异位52例，过深异位12例，右折3例，左折2例，导管前端打折并卷曲1例，异位率达37.6%；置入中心静脉128例（含退出至适当深度后仍可作为中心静脉使用的12例过深异位者），成功率68.8%；部分置管过浅者可能已经置于下腔静脉，因X线定位的不确定性，不能作为中心静脉使用。 结论 新生儿脐静脉置管术异位率较高，术者可以通过改进操作技术来减少异位发生；超声的应用可能可以减少UVC异位发生，从而提高中心静脉置管成功率。 　　[关键词] 脐静脉；中心静脉置管；异位；新生儿；UVC 　　[中图分类号] R472 [文献标识码] B [文章编号] 2095-0616（2015）14-54-03 　　Clinical analysis of catheter misplacement of umbilical veous catheters in 70 infants 　　HUANG Aiqun LIN Li YE Rundi PENG Kangda ZHANG Jing 　　Tangxia Hospital of Dongguan，Dongguan 523710，China 　　[Abstracts] Objective To observe the catheter misplacement of umbilical venous catheters（UVC） in infants and try to find its solution. Methods 186 infants who were carried UVC were retrospectively analyzed，and the causes and possible solutions of catheter misplacement were analyzed. Results 70 of all 186 infants had been founded catheter misplacement，which included 52 infants with shallower misplacement，12 infants with deeper misplacement，3 infants with right-fold misplacement，2 infants with left-fold misplacement and 1 infant with catheter of front-end fold and curled up.The incidence of misplacement was 37.6%.Catheters were indwelt in a central vein in 128 infants （including 12 infants with deeper misplacement whose catheters were exited to the appropriate depth and used as a central vein），the successful rate of UVC was 68.8%.However，some catheters of shallower misplacement might had been placed into the inferior vena cava，those could not use as a central vein due to the uncertainty of X-ray locating. Conclusion Occurrence of catheter misplacement in neonatal UVC is high，and improving technology of performers can reduce the misplacement.The application of ultrasound might reduce the occurrence of catheter misplacement in UVC so as to improve the success rate of central venous catheter. 　　[Key words] Umbilical vein；Central venous catheter；Mi