新生儿下肢外周中心静脉导管相关并发症的影响因素分析
|
摘要
目的分析新生儿下肢外周中心静脉导管(peripherally inserted central venous catheter,PICC)相关并发症的影响因素,并探讨防治对策。方法回顾性分析本院2012年6月至2018年6月收治的1066例行下肢PICC置管的新生儿的临床资料。按照PICC相关并发症发生情况,将其分别纳入并发症组和无并发症组,比较两组新生儿胎龄、出生体重、穿刺次数、留置时间等临床资料,采用多因素Logistic回归分析探讨新生儿下肢PICC相关并发症的影响因素。结果 1066例新生儿中,共有72例发生导管相关并发症,发生率为6.75%;以导管相关血行感染最为常见,占63.89%。多因素Logistic回归分析显示,出生体重<2500 g、基础疾病为感染性疾病均为影响新生儿下肢PICC相关并发症的独立危险因素(P_均<0.05)。结论新生儿下肢PICC相关并发症的发生与出生体重、感染性疾病有关,临床上应重视高危新生儿的识别与干预。
Objective To analyze the in?uence factors of complications related to peripherally inserted central venous catheter(PICC) in neonatal lower limbs and explore the preventive and therapeutic strategies. Method The clinical data of 1066 neonates with PICC catheterization in lower limbs admitted to our hospital from June 2012 to June 2018 were analyzed retrospectively.According to the occurrence of PICC-related complications, they were included in complication group and non-complication group respectively. The clinical data such as gestational age, birth weight, puncture times and indwelling time were compared between the two groups. Multivariate Logistic regression analysis was used to summarize the relevant factors affecting complications of PICC in neonatal lower limbs. Result Among 1066 neonates, 72 cases had catheter-related complications(6.75%). Catheter-related bloodstream infection was the most common catheter-related complications(63.89%). Multivariate Logistic regression analysis showed that birth weight < 2500 g and infectious diseases were independent risk factors of complications related to PICC in neonatal lower limbs(P_(all)< 0.05). Conclusion The complications of PICC in neonatal lower limbs is related to birth weight and infectious diseases, and attention should be paid to the identi?cation and intervention of high-risk neonates.
Objective To analyze the in?uence factors of complications related to peripherally inserted central venous catheter(PICC) in neonatal lower limbs and explore the preventive and therapeutic strategies. Method The clinical data of 1066 neonates with PICC catheterization in lower limbs admitted to our hospital from June 2012 to June 2018 were analyzed retrospectively.According to the occurrence of PICC-related complications, they were included in complication group and non-complication group respectively. The clinical data such as gestational age, birth weight, puncture times and indwelling time were compared between the two groups. Multivariate Logistic regression analysis was used to summarize the relevant factors affecting complications of PICC in neonatal lower limbs. Result Among 1066 neonates, 72 cases had catheter-related complications(6.75%). Catheter-related bloodstream infection was the most common catheter-related complications(63.89%). Multivariate Logistic regression analysis showed that birth weight < 2500 g and infectious diseases were independent risk factors of complications related to PICC in neonatal lower limbs(P_(all)< 0.05). Conclusion The complications of PICC in neonatal lower limbs is related to birth weight and infectious diseases, and attention should be paid to the identi?cation and intervention of high-risk neonates.
引文
[1]Van den Berg J,L??f?str?m J,Olofsson J,et al.Peripherally inserted central catheter in extremely preterm infants:Characteristics and influencing factors[J].J Neonatal Perinatal Med,2017,10(1):63-70.
[2]孙翠梅.新生儿上下肢静脉PICC置管的穿刺效果比较[J].护理管理杂志,2018,18(10):71-73.
[3]Tolera BD,Hui F.Exploring Individual and Organizational factors influencing registered nurses in preventing peripherally inserted central catheter related complication[J].Int J Med Pharmaceut Sci,2017,4(4):1-12.
[4]Ling Q,Chen H,Tang M,et al.Accuracy and Safety Study of Intracavitary Electrocardiographic Guidance for Peripherally Inserted Central Catheter Placement in Neonates[J].J Perinat Neonatal Nurs,2019,33(1):89-95.
[5]陆丽华,谭宝琴,韦婷.经外周置入中心静脉导管置管在新生儿重症监护室中的临床应用与护理[J].中国医刊,2015,50(6):70-72.
[6]Soares BN,Pissarra S,Rouxinol-Dias AL,et al.Complications of central lines in neonates admitted to a level III Neonatal Intensive Care Unit[J].J Matern Fetal Neonatal Med,2018,31(20):2770-2776.
[7]戎惠,陈秀利,李芳.新生儿PICC导管堵塞的相关因素分析[J].江苏医药,2015,41(14):1728-1729.
[8]Zhou LJ,Xua HZ,Xu MF,et al.An Accuracy Study of the Intracavitary Electrocardiogram(IC-ECG)Guided Peripherally Inserted Central Catheter Tip Placement among Neonates[J].Open Med,2017,12:125-130.
[9]王玥.新生儿三种PICC置管途径的使用分析[J].中西医结合护理(中英文),2017,3(8):35-38.
[10]Noonan PJ,Hanson SJ,Simpson PM,et al.Comparison of Complication Rates of Central Venous Catheters Versus Peripherally Inserted Central Venous Catheters in Pediatric Patients[J].Pediatr Crit Care Med,2018,19(12):1097-1105.
[11]廖和平,贺连香.新生儿经股静脉穿刺置入PICC的可行性探讨[J].全科护理,2018,16(32):50-53.
[12]李智英,司徒妙琼,吕林华.低出生体质量儿PICC置管后导管相关并发症的相关因素分析[J].重庆医学,2017,46(34):4886-4888.
[13]Page D,Gilroy M,Hurrion E,et al.Optimising early neonatal nutrition using translational research methodology[J].Nutr Diet,2017,74(5):460-470.
[14]Barone G,D'Andrea V,Vento G,et al.A Systematic Ultrasound Evaluation of the Diameter of Deep Veins in the Newborn:Results and Implications for Clinical Practice[J].Neonatology,2019,115(4):335-340.
[15]高丽华,李小燕,吴容燕,等.新生儿经不同外周静脉置入PICC导管的临床观察及分析[J].中国医学创新,2017,14(2):137-141.
[16]陈春玲.不同方法预防PICC置管后机械性静脉炎的效果研究[J].中国医学前沿杂志(电子版),2016,8(6):180-183.
[2]孙翠梅.新生儿上下肢静脉PICC置管的穿刺效果比较[J].护理管理杂志,2018,18(10):71-73.
[3]Tolera BD,Hui F.Exploring Individual and Organizational factors influencing registered nurses in preventing peripherally inserted central catheter related complication[J].Int J Med Pharmaceut Sci,2017,4(4):1-12.
[4]Ling Q,Chen H,Tang M,et al.Accuracy and Safety Study of Intracavitary Electrocardiographic Guidance for Peripherally Inserted Central Catheter Placement in Neonates[J].J Perinat Neonatal Nurs,2019,33(1):89-95.
[5]陆丽华,谭宝琴,韦婷.经外周置入中心静脉导管置管在新生儿重症监护室中的临床应用与护理[J].中国医刊,2015,50(6):70-72.
[6]Soares BN,Pissarra S,Rouxinol-Dias AL,et al.Complications of central lines in neonates admitted to a level III Neonatal Intensive Care Unit[J].J Matern Fetal Neonatal Med,2018,31(20):2770-2776.
[7]戎惠,陈秀利,李芳.新生儿PICC导管堵塞的相关因素分析[J].江苏医药,2015,41(14):1728-1729.
[8]Zhou LJ,Xua HZ,Xu MF,et al.An Accuracy Study of the Intracavitary Electrocardiogram(IC-ECG)Guided Peripherally Inserted Central Catheter Tip Placement among Neonates[J].Open Med,2017,12:125-130.
[9]王玥.新生儿三种PICC置管途径的使用分析[J].中西医结合护理(中英文),2017,3(8):35-38.
[10]Noonan PJ,Hanson SJ,Simpson PM,et al.Comparison of Complication Rates of Central Venous Catheters Versus Peripherally Inserted Central Venous Catheters in Pediatric Patients[J].Pediatr Crit Care Med,2018,19(12):1097-1105.
[11]廖和平,贺连香.新生儿经股静脉穿刺置入PICC的可行性探讨[J].全科护理,2018,16(32):50-53.
[12]李智英,司徒妙琼,吕林华.低出生体质量儿PICC置管后导管相关并发症的相关因素分析[J].重庆医学,2017,46(34):4886-4888.
[13]Page D,Gilroy M,Hurrion E,et al.Optimising early neonatal nutrition using translational research methodology[J].Nutr Diet,2017,74(5):460-470.
[14]Barone G,D'Andrea V,Vento G,et al.A Systematic Ultrasound Evaluation of the Diameter of Deep Veins in the Newborn:Results and Implications for Clinical Practice[J].Neonatology,2019,115(4):335-340.
[15]高丽华,李小燕,吴容燕,等.新生儿经不同外周静脉置入PICC导管的临床观察及分析[J].中国医学创新,2017,14(2):137-141.
[16]陈春玲.不同方法预防PICC置管后机械性静脉炎的效果研究[J].中国医学前沿杂志(电子版),2016,8(6):180-183.