摘要
目的探讨超声检测在新生儿经皮外周静脉置入中心静脉导管(PICC)尖端定位中的应用价值。方法对北京市朝阳区妇幼保健院新生儿科2017年6月至2018年12月经超声定位的PICC置管情况进行回顾性分析,患儿均在置管完成后立即使用超声进行定位。将探头置于剑突下中线位置或锁骨下胸骨旁线位置进行扫查,当超声发现高回声"等号线"样结构即为PICC,如PICC尖端位于下腔静脉或上腔静脉与右心房的交界处为置管成功。结果(1)在112例置管患儿中,经超声定位显示1次准确到位103例(一次置管准确率为92.0%),9例(8.0%)位置超出理想范围,其中置管过深2例、过浅4例、异位3例。首次超声检查显示导管尖端位置不理想者,在超声检测下进行调整后均位置准确。(2)PICC留置时间最短2 d(因发生严重心律失常而拔除),最长56d,平均(15.1±10.7)d。(3)发生导管相关性并发症3例,发生率为2.7%。结论使用超声进行PICC尖端定位及时、准确、可靠,值得在新生儿病房内推广应用。
Objective To investigate the value of ultrasound in the localization of peripherally inserted central catheter(PICC)in neonates.Methods A retrospective analysis of the PICC catheterization was conducted at Department of Neonatology,Beijing Chaoyang District Maternal and Child Healthcare Hospital from June 2017 to December 2018.The ultrasound monitoring was performed immediately after PICC catheterization.The probe was placed into the midline position of the lower xiphoid or the subclavian parasternal line for scanning,and it would be the PICC if a high-echo"equal sign"was observed by ultrasound.It was believed that the PICC was successfully placed when ultrasound detected that the PICC tip was located in the junction of inferior vena cava or superior vena cava in the right atrium.Results(1)Among 112 infants with PICC catheterization,103 cases(92.0%)were accurately placed,9 cases(8.0%)were not placed in the ideal site,among them,2 cases were too deep,4 cases were too shallow and 3 cases were catheter heterotopia.The tip position was accurate after the readjustment under ultrasound monitoring in those patients whose the first ultrasound showed the tip position was not ideal.(2)The PICC indwelling time was as short as 2 days(removed due to severe arrhythmia)and as long as 56 days with an average of(15.1±10.7)days.(3)The catheter-related complications occurred in 3 cases with an incidence of 2.7%.Conclusions Using ultrasound to determine the PICC tips position is accurate and reliable,which is worthy of extensive application in the neonatal wards.
作者
任晓玲
陈亚娟
刘敬
王嫚
申佳
高月乔
邱如新
Ren Xiaoling;Chen Yajuan;Liu Jing;Wang Man;Shen Jia;Gao Yueqiao;Qiu Ruxin(Department of Neonatology,Beijing Chaoyang District Maternal and Child Healthcare Hospital,Beijing 100021,China)
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2019年第18期1398-1401,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
北京市朝阳区科信局社会发展项目科研基金(CYSF1922).
关键词
超声
外周静脉置入中心静脉导管
婴儿
新生
Ultrasound
Peripherally inserted central catheter
Infant,newborn
