CAJ | 학술논문

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.
목적 탐토신생인제정맥치관술적이위정황급해결판법.방법 대186례신생인실시UVC적이위정황진행회고성분석,분석상관UVC이위발생원인급가능해결판법.결과 186례신생인실시UVC술,발생이위70례,기중과천이위52례,과심이위12례,우절3례,좌절2례,도관전단타절병권곡1례,이위솔체37.6%;치입중심정맥128례(함퇴출지괄당심도후잉가작위중심정맥사용적12례과심이위자),성공솔68.8%;부분치관과천자가능이경치우하강정맥,인X선정위적불학정성,불능작위중심정맥사용. 결론 신생인제정맥치관술이위솔교고,술자가이통과개진조작기술래감소이위발생;초성적응용가능가이감소UVC이위발생,종이제고중심정맥치관성공솔.
s] 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.