Abstract:

Objective　To explore and analyze the application effects of peripherally inserted central catheters (PICC) through different catheterization approaches (upper and lower limb catheterization) in premature infants. Methods　One hundred and twenty premature infants who took PICC catheterization at Guangdong Maternal and Child Health Hospital from June 2023 to August 2024 were selected for the prospective study. According to the catheterization approaches (upper and lower limb catheterization), they were divided into a study group and a control group, with 60 cases in each group. The study group had 60 males and 21 females; their gestational age was (28.0±2.3) weeks; the catheterization weight was (1.46±0.20) kg. The control group had 60 males and 22 females; their gestational age was (29.0±2.2) weeks; the catheterization weight was (1.35±0.10) kg. The study group took catheterization through lower limb veins, and the control group through upper limb veins. The operation times, bleeding volumes, catheter retention times, incidence rates of complications, success rates of catheterization at one time, one successful puncture rate, and ectopic incidence rates were compared between the two groups by t and χ² tests. Results　The catheterization operation time, puncture point bleeding volume, and catheter retention time in the study group were better than those in the control group [(24.62±2.11) min vs. (32.53±2.29) min, (1.01±0.20) ml vs. (1.98±0.55) ml, and (16.50±4.10) d vs. (14.60±4.20) d], with statistical differences (all P<0.05). The success rate of catheterization and successful puncture rate at one time in the study group were higher than those in the control group [98.33% (59/60) vs. 88.33% (53/60) and 98.33% (59/60) vs. 75.00% (45/60)], with statistical differences (both P<0.05). The incidence rates of complications and the ectopic rate in the study group were lower than those in the control group [5.00% (3/60) vs. 16.67% (10/60) and 3.33% (2/60) vs. 13.33% (8/60)], with statistical differences (both P<0.05). Conclusion　PICC catheterization lower through limb veins has fewer complications, better safety, and a higher success rate, so it the first choice for PICC catheterization.

Key words:

Premature infants, Peripherally inserted central catheter, Different catheterization approaches, Application effect

摘要：

目的　探讨经外周静脉置入中心静脉导管（PICC）不同置管途径（上肢与下肢）在早产儿中的应用效果。方法　采用前瞻性研究，选取2023年6月至2024年8月广东省妇幼保健院新生儿科接收的120例需行PICC置管的早产儿，按置管途径不同分为研究组与对照组，各60例。研究组中，男39例、女21例，胎龄（28.0±2.3）周，置管时早产儿体重（1.46±0.20）kg，给予下肢静脉置管；对照组中，男38例、女22例，胎龄（29.0±2.2）周，置管时早产儿体重（1.35±0.10）kg，给予上肢静脉置管。比较两组早产儿PICC置管的操作时间、出血量、导管留置时间、一次置管成功率、一次成功穿刺率、并发症及异位发生率。采用t检验、χ²检验进行统计比较。结果　研究组置管操作时间为（24.62±2.11）min、穿刺点出血量为（1.01±0.20）ml、导管留置时间为（16.50±4.10）d，对照组分别为（32.53±2.29）min、（1.98±0.55）ml和（14.60±4.20）d，差异均有统计学意义（均P<0.05）；研究组一次置管成功率98.33%（59/60）、一次成功穿刺率98.33%（59/60），高于对照组的88.33%（53/60）、75.00%（45/60），差异均有统计学意义（均P<0.05）；研究组并发症发生率为5.00%（3/60）、异位生率为3.33%（2/60），对照组分别为16.67%（10/60）、13.33%（8/60），差异均有统计学意义（均P<0.05）。结论　下肢静脉PICC置管并发症少，安全性好，一次成功率高，是PICC置管首选方式。

关键词:

早产儿, 经外周静脉置入中心静脉导管, 置管途径, 应用效果