CAJ | 학술논문

目的对影响早产儿经下肢浅静脉置入中心静脉导管成功率的因素进行分析，为建立早产儿PICC的临床操作标准提供依据。方法分析2012年2月～2014年2月我科收治的108例行下肢浅静脉置入中心静脉导管治疗的危重早产儿的临床资料，并进行置管成功率多因素探讨，分析胎龄、体重、穿刺部位及置管后静脉炎、堵管、感染、脱管等并发症发生率等对置管成功率的影响，双盲记录108例患儿临床治疗情况及置管结果。结果108例患儿中99例置管成功，成功率为91．67％；应用多项Logistic主效应模型回归分析，早产儿胎龄、体重及置管后静脉炎、堵管、感染、脱管等并发症是影响置管成功的关键因素。结论危重早产儿经下肢浅静脉置入中心静脉导管作为外周静脉置入中心静脉导管的备选途径，可有效解决上肢静脉条件差的危重早产儿中心静脉导管置入问题。早产儿胎龄、体重及置管后静脉炎、堵管、感染、脱管等并发症发生率对经下肢浅静脉置入中心静脉导管操作的成功起影响作用。
목적대영향조산인경하지천정맥치입중심정맥도관성공솔적인소진행분석，위건립조산인PICC적림상조작표준제공의거。방법분석2012년2월～2014년2월아과수치적108례행하지천정맥치입중심정맥도관치료적위중조산인적림상자료，병진행치관성공솔다인소탐토，분석태령、체중、천자부위급치관후정맥염、도관、감염、탈관등병발증발생솔등대치관성공솔적영향，쌍맹기록108례환인림상치료정황급치관결과。결과108례환인중99례치관성공，성공솔위91．67％；응용다항Logistic주효응모형회귀분석，조산인태령、체중급치관후정맥염、도관、감염、탈관등병발증시영향치관성공적관건인소。결론위중조산인경하지천정맥치입중심정맥도관작위외주정맥치입중심정맥도관적비선도경，가유효해결상지정맥조건차적위중조산인중심정맥도관치입문제。조산인태령、체중급치관후정맥염、도관、감염、탈관등병발증발생솔대경하지천정맥치입중심정맥도관조작적성공기영향작용。
Objective To study the factors that influenced the success rate of premature by superficial vein in central ve‐nous catheter ,And do preliminary research for building the future premature usm clinical operating standards .Methods A retrospective analysis in February 2012‐February 2014 during the records of 108 patients with lower limb in our new pediat‐ric superficial vein in central venous catheter in the treatment of the critically ill premature infants ,and success rate of cathe‐ter multi‐factor ,statistical analysis of gestational age ,weight ,puncture and catheter after phlebitis ,blocking pipe ,inci‐dence of complications such as infection ,pipe ,and so on and so forth the impact on the success rate of catheter ,double‐blind recorded 108 cases of clinical treatment and the result of catheter .Results 108 cases of children with 99 cases of placement success ,the success rate was 91 .67% ;With Multinomial Logistic regression analysis ,the main effect model of premature gestational age ,weight and phlebitis after catheter ,blocking pipe ,complications such as infection ,take off the tube were the key factors influencing the success .Conclusion Critically ill premature by central venous catheter as superficial vein of lower limb in peripheral vein in the alternative way to central venous catheter ,can effectively solve the poor upper limb vein condition of central venous catheter placement problem ,critically ill premature premature gestational age、weight and phlebi‐tis after catheter ,blocking pipe ,incidence of complications such as infection ,take off the tube of the lower extremity super‐ficial vein in central venous catheter plays a role of influence the success of the operation .