经外周置入中心静脉导管在高危新生儿应用的临床评估

Evaluation of peripherally inserted central catheters in high risk newborns

摘要:

目的：观察新生儿应用经外周置入中心静脉导管（peripherally inserted central catheters, PICC）的优缺点，为需要长期使用静脉治疗的患儿寻找稳定有效的手段。方法：采用回顾性队列研究方法，以2006年4月至2008年2月间在该科住院，使用PICC的65例新生儿和使用外周静脉留置针(peripheral intravenous catheters, PIV)的80例新生儿为研究对象，分别对两组患儿导管留置时间、导管机械性并发症、败血症以及死亡情况进行比较。结果：PICC的置留时间为18.75±7.62 d（7~62 d）；PIV为1.49±0.57 d（0.5 h至4 d），PICC明显长于PIV（P<0.01）；PICC组机械性并发症发生率为27.7%，PIV组为63.8%，PICC组明显低于PIV组（P<0.01）；PICC与 PIV组的败血症发生率以及死亡率比较差异无显著性意义。结论：PICC对新生儿是一项安全有效的治疗措施，能够明显减少静脉穿刺次数。［中国当代儿科杂志，2009，11（2）：100-103］

Abstract:

OBJECTIVE: To evaluate the feasibility and safety of the peripherally inserted central catheters (PICC) as a venous access for newborns who need a long-term venous transfusion. METHODS: Sixty-five newborns receiving PICC and 80 newborns receiving peripheral intravenous catheters (PIV) from April 2006 to February 2008 were included in this study. A retrospective cohort study was used to compare the indwelling time of catheters, catheter-related mechanical complications, the incidence of sepsis, and the mortality between the two groups. RESULTS: The indwelling time of catheters in the PICC and the PIV groups was 18.75±7.62 days (range:7-62 days) and 1.49±0.57 days (range: 30 minutes to 4 days) respectively. The indwelling time of catheters in the PICC group was significantly longer than that in the PIV group (P<0.01). The incidence of catheter-related mechanical complications in the PICC group was significantly lower than that in the PIV group (27.7% vs 63.8%; P<0.01). There were no significant differences in the incidence of sepsis and the mortality between the two groups. CONCLUSIONS: The application of PICC can cause a decrease in the number of venous puncture. PICC is a safe and effective venous access in newborns.［Chin J Contemp Pediatr, 2009, 11 (2):100-103］