中国小儿急救医学
中國小兒急救醫學
중국소인급구의학
CHINESE PEDIATRIC EMERGENCY MEDICINE
2013年
3期
283-286
,共4页
脐静脉置管术%极低出生体重%婴儿,早产
臍靜脈置管術%極低齣生體重%嬰兒,早產
제정맥치관술%겁저출생체중%영인,조산
Umbilical vein catheterization%Very low birth weight infant%Infant,premature
目的 探讨脐静脉置管在极低或低出生体重儿的应用.方法 对我科新生儿重症监护病房2011年6月至2013年1月进行脐静脉置管术的极低或低出生体重儿置管术后的临床情况进行总结.结果 63例患儿均成功置管,其中成功置管于下腔静脉41例(65.1％).留置时间4～21 d,平均12.9d.留置导管期间非计划拔管11例,其中置管于脐静脉非计划拔管8例,不同置管位置的非计划拔管发生率差异有统计学意义(x2=8.38,P＜0.01).本组均在生后36 h内插管,插管时间不同的患儿置管于下腔静脉成功率差异无统计学意义(x2=0.223,P＞0.1).置管期间5例发生疑似导管相关感染,感染率为6.2/1000血管内导管日,63例拔管后同时行导管末端培养和血培养,结果导管末端细菌培养阳性1例(1.6％),酵母样真菌阳性1例(1.6％),导管留置时间不同的患儿导管相关感染发生率的差异无统计学意义(x2 =0.075,P＞0.95).结论 脐静脉置管术可以在早产(极)低出生体重儿出生后早期应用.
目的 探討臍靜脈置管在極低或低齣生體重兒的應用.方法 對我科新生兒重癥鑑護病房2011年6月至2013年1月進行臍靜脈置管術的極低或低齣生體重兒置管術後的臨床情況進行總結.結果 63例患兒均成功置管,其中成功置管于下腔靜脈41例(65.1％).留置時間4～21 d,平均12.9d.留置導管期間非計劃拔管11例,其中置管于臍靜脈非計劃拔管8例,不同置管位置的非計劃拔管髮生率差異有統計學意義(x2=8.38,P＜0.01).本組均在生後36 h內插管,插管時間不同的患兒置管于下腔靜脈成功率差異無統計學意義(x2=0.223,P＞0.1).置管期間5例髮生疑似導管相關感染,感染率為6.2/1000血管內導管日,63例拔管後同時行導管末耑培養和血培養,結果導管末耑細菌培養暘性1例(1.6％),酵母樣真菌暘性1例(1.6％),導管留置時間不同的患兒導管相關感染髮生率的差異無統計學意義(x2 =0.075,P＞0.95).結論 臍靜脈置管術可以在早產(極)低齣生體重兒齣生後早期應用.
목적 탐토제정맥치관재겁저혹저출생체중인적응용.방법 대아과신생인중증감호병방2011년6월지2013년1월진행제정맥치관술적겁저혹저출생체중인치관술후적림상정황진행총결.결과 63례환인균성공치관,기중성공치관우하강정맥41례(65.1％).류치시간4～21 d,평균12.9d.류치도관기간비계화발관11례,기중치관우제정맥비계화발관8례,불동치관위치적비계화발관발생솔차이유통계학의의(x2=8.38,P＜0.01).본조균재생후36 h내삽관,삽관시간불동적환인치관우하강정맥성공솔차이무통계학의의(x2=0.223,P＞0.1).치관기간5례발생의사도관상관감염,감염솔위6.2/1000혈관내도관일,63례발관후동시행도관말단배양화혈배양,결과도관말단세균배양양성1례(1.6％),효모양진균양성1례(1.6％),도관류치시간불동적환인도관상관감염발생솔적차이무통계학의의(x2 =0.075,P＞0.95).결론 제정맥치관술가이재조산(겁)저출생체중인출생후조기응용.
Objective To probe the application of umbilical vein catheterization among the verylow-birth-weight or the low-birth-weight children.Methods In this retrospective study,the clinical condition of the very-low-birth-weight or the low-birth-weight infants in neonatal intensive care unit who had umbilical vein catheterization from June 2011 to January 2013 was concluded.Results Sixty-three cases were successfully catheterized,of which 41 cases were catheterized in inferior vena cava(65.1％).The retention time was 4 to 21 days,with an average of 12.9 days.Eleven cases suffered unplanned extubation of the indwelling catheters,and eight of them were located in the umbilical vein.There were statistically significant differences of unplanned extubation rates among different location of the catheters (x2 =8.38,P ＜ 0.01).All cases were intubated within 36 hours after birth,and the intubation time was not positively correlated to the success rate of catheterization in the inferior vena cava (x2 =0.223,P ＞ 0.1).Suspected catheter-related infections occurred in 5 cases and the infection rate was 6.2/1000 per intravascular catheter day.After extubation,bacterial cultures of the tips of the catheters and blood were arranged.The results suggest that the bacterial culture of the catheter tip was positive in only 1 case(1.6％),and yeast-like fungus was positive in 1 case (1.6％),while the retention time and incidence of catheter-related infection had no significant corelation(x2 =0.075,P ＞ 0.95).Conclusion Umbilical vein catheterization could be used at the early stage in preterm (very) low-birth-weight infants.
