脐静脉联合外周中心静脉置管在极低出生体重儿中的应用

杨祖铭; 王三南; 马月兰; 杨晓路; 张文瑛; 朱梅英

doi:10.7499/j.issn.1008-8830.2013.05.008

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中国当代儿科杂志 ›› 2013, Vol. 15 ›› Issue (5) : 353-355. DOI: 10.7499/j.issn.1008-8830.2013.05.008

论著·临床研究

脐静脉联合外周中心静脉置管在极低出生体重儿中的应用

杨祖铭，王三南，马月兰，杨晓路，张文瑛，朱梅英

作者信息 +

Application of umbilical venous catheter combined with peripherally inserted central catheter in very low birth weight infants

YANG Zu-Ming, WANG San-Nan, MA Yue-Lan, YANG Xiao-Lu, ZHANG Wen-Ying, ZHU Mei-Ying

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文章历史 +

摘要

目的：研究脐静脉联合外周中心静脉置管在极低出生体重儿中的应用。方法：回顾性分析新生儿重症监护病房极低出生体重儿脐静脉联合外周中心静脉置管的应用，比较导管组（63例）与非导管组（38例）在院内感染、体重增长情况及住院天数方面的差异。结果：导管组院内感染率（17%）与非导管组感染率（24%）差异无统计学意义；导管组体重增长（11.7±2.0 g/kg?d）明显高于非导管组（10.6±2.3 g/kg?d）；导管组的住院天数（40±11 d）明显短于非导管组（45±14 d）；导管组早产儿相关并发症的发生率与非导管组的差异没有统计学意义。结论：脐静脉联合外周中心静脉置管在极低出生体重儿的应用中，早产儿体重的增长显著优于非导管组，住院天数明显缩短，而且院内感染有下降的趋势。

Abstract

OBJECTIVE: To study the application of umbilical venous catheter (UVC) combined with peripherally inserted central catheter (PICC) in very low birth weight infants (VLBWIs). METHODS: A retrospective analysis was performed on the VLBWIs in the neonatal intensive care unit who received UVC combined with PICC (catheter group, n=63) or did not receive the catheter treatment (non-catheter group, n=38) to compare the differences in nosocomial infection, weight gain, and length of hospital stay between the two groups. RESULTS: The rate of nosocomial infection was 17% in the catheter group and 24% in the non-catheter group (P>0.05). Compared with the non-catheter group, the catheter group had a significantly higher weight gain (11.7±2.0 g/kg?d vs 10.6±2.3 g/kg?d; P<0.05) and a significantly shorter length of hospital stay (40±11 days vs 45±14 days; P<0.05). There was no significant difference in the incidence of complications between the two groups. CONCLUSIONS: Compared with those not receiving catheter treatment, the VLBWIs receiving UVC combined with PICC have a markedly higher weight gain and a markedly shorter length of hospital stay and show a declining trend in the rate of nosocomial infection.

导出引用

杨祖铭，王三南，马月兰，杨晓路，张文瑛，朱梅英. 脐静脉联合外周中心静脉置管在极低出生体重儿中的应用[J]. 中国当代儿科杂志. 2013, 15(5): 353-355 https://doi.org/10.7499/j.issn.1008-8830.2013.05.008

YANG Zu-Ming, WANG San-Nan, MA Yue-Lan, YANG Xiao-Lu, ZHANG Wen-Ying, ZHU Mei-Ying. Application of umbilical venous catheter combined with peripherally inserted central catheter in very low birth weight infants[J]. Chinese Journal of Contemporary Pediatrics. 2013, 15(5): 353-355 https://doi.org/10.7499/j.issn.1008-8830.2013.05.008

参考文献

［1］ButlerO′Hara M, D′Angio CT, Hoey H, Stevens TP. An evidence-based catheter bundle alters central venous catheter strategy in newborn infants［J］. J Pediatr, 2012, 160(6): 972-977.

［2］黑明燕，赵玲玲，伍志翔，田朗，谭彦娟. 新生儿经脐静脉中心静脉置管相关感染的临床研究［J］. 中国当代儿科杂志，2010,12(8):619-621.

［3］吴燕云，麦友刚，赖文玉，张红珊，苏浩彬. 脐静脉置管在超低或极低出生体重儿的应用［J］. 中国新生儿科杂志，2012,1(1):42-43.

［4］Parry G, Tucker J, Tarnow-Mordi W; UK Neonatal Staffing Study Collaborative Group. CRIB II: an update of the clinical risk index for babies score［J］. Lancet, 2003, 361(9371): 1789-1791.

［5］邵肖梅，叶鸿瑁，丘小汕.实用新生儿学［M］. 第4版.北京：人民卫生出版. 2011：923.

［6］吴旭红，马爱萍，杨颖，钟学红，孙丛莉，谢帅华. 早产儿PICC液体渗出的相关因素［J］.中国临床营养杂志，2008，16（1）：58-59.

［7］Vali P, Fleming SE, Kim JH. Determination of umbilical catheter placement using anatomic landmarks［J］. Neonatology, 2010, 98(4): 381-386.

［8］Oestreich AE. Umbilical vein catheterization-appropriate and inappropriate placement［J］. Pediatr Radiol, 2010, 40(12): 1941-1949.

［9］Polin RA, Denson S, Brady MT; Committee on Fetus and Newborn; Committee on Infections Diseases. Epidemiology and diagnosis of health care-associated infections in the NICU［J］. Pediatrics, 2012, 129(4): e1104-e1109.

［10］Hornik CP, Fort P, Clark RH, Watt K, Benjamin DK Jr, Smith PB, et al. Early and late onset sepsis in very-low-birth-weight infants from a large group of neonatal intensive care units［J］. Early Hum Dev, 2012, 88, (Suppl 2): S69-S74.

［11］谢微微，余海英，罗荣眉，鲁萍，胡丹元. 极低出生体质量儿建立静脉输液通路方式的比较［J］. 护理学报，2009，16（10B）：59-62.

［12］Ainsworth SB, Clerihew L, McGuire W. Percutaneous central venous catheters versus peripheral cannulae for delivery of parenteral nutrition in neonates［J］. Cochrane Database Syst Rev, 2007, 18(3): CD004219.