本文關(guān)鍵詞：經(jīng)外周穿刺中心靜脈導(dǎo)管在普通兒科病房中長(zhǎng)期輸液患兒應(yīng)用的可行性研究　出處：《中國循證兒科雜志》2017年02期 　論文類型：期刊論文

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【摘要】：目的分析經(jīng)外周穿刺中心靜脈導(dǎo)管(PICC)在普通兒科病房中需中長(zhǎng)期輸液患兒中應(yīng)用的必要性及可行性,為普通兒科病房開展PICC置管提供依據(jù)。方法納入2015年12月至2017年2月在復(fù)旦大學(xué)附屬兒科醫(yī)院呼吸和消化科病房住院的符合PICC適應(yīng)證且監(jiān)護(hù)人同意PICC置管的連續(xù)病例,對(duì)置管原因、并發(fā)癥、導(dǎo)管結(jié)局及相關(guān)效應(yīng)指標(biāo)進(jìn)行分析。結(jié)果 60例PICC置管患兒(其中1例為禁忌證置管)進(jìn)入本文分析,男38例,女22例,年齡1月4 d至14歲。置管原因包括輸注胃腸外營(yíng)養(yǎng)(PN)45例(75.0%),靜脈輸液6 d 9例(15.0%),可預(yù)計(jì)的外周靜脈通道無可選擇的風(fēng)險(xiǎn)6例(10.0%)。導(dǎo)管實(shí)際留置時(shí)間(17.2±10.7)d,總留置時(shí)間為1 033導(dǎo)管日。22例患兒出現(xiàn)并發(fā)癥23例次(22.3例次/1 000導(dǎo)管日)。其中,導(dǎo)管異位7例次,導(dǎo)管堵塞6例次,靜脈炎3例次,導(dǎo)管破/斷裂3例次,誤傷動(dòng)脈2例次,靜脈痙攣1例次,靜脈回流受阻1例次。經(jīng)原位治療后18例次導(dǎo)管繼續(xù)使用,5例次拔管。導(dǎo)管結(jié)局:計(jì)劃拔管42例(70.0%),非計(jì)劃拔管5例(8.3%),包括導(dǎo)管破/斷裂、導(dǎo)管堵塞無法再通各2例,無法糾正的靜脈回流受阻1例,帶管轉(zhuǎn)科/出院13例(21.7%)。平均穿刺時(shí)間(68.2±43.5)min,PICC置管費(fèi)用/住院總費(fèi)用為7%。結(jié)論普通兒科病房中長(zhǎng)期輸液患兒行PICC置管必要且可行,使用中需加強(qiáng)并發(fā)癥的預(yù)防和處理。
[Abstract]:Objective to analyze the necessity and feasibility of the application of central venous catheter (PICCC) through peripheral puncture in children who need medium and long term infusion in general pediatric ward. To provide the basis for PICC catheterization in general pediatrics wards. Methods to include PICC adaptation in respiratory and digestive wards of pediatrics hospital affiliated to Fudan University from December 2015 to February 2017. A continuous case in which the guardian consents to the placement of PICC. Results 60 cases of children with PICC catheterization (including 1 case of contraindications) were analyzed in this paper, 38 cases were male and 22 cases were female. The causes of catheterization included 45 patients with parenteral nutrition (PNN) and 45 patients with parenteral nutrition (PNN), and 9 patients were given intravenous infusion for 6 days (n = 9). The estimated risk of no choice of peripheral venous passage was 10.0 in 6 cases. The actual indwelling time of catheter was 17.2 鹵10.7 days. The total indwelling time was 1 033 catheter days. 22 cases had complications 23 times, 22.3 cases per 1 000 ducts, including 7 cases of ectopic ducts and 6 cases of catheter blockage. There were 3 cases of phlebitis, 3 cases of catheter rupture / rupture, 2 cases of artery injury, 1 case of venous spasm and 1 case of obstruction of venous reflux. Catheter outcome: planned extubation was performed in 42 cases (70.0%) and unplanned extubation in 5 cases (8.3%), including rupture / rupture of the catheter and obstruction of the catheter (2 cases). There were 1 case of obstruction of venous reflux which could not be corrected, and 13 cases were transferred to department with tube / discharged from hospital. The average puncture time was 68.2 鹵43.5 minutes. The total cost of PICC catheterization / hospitalization was 70.Conclusion PICC catheterization is necessary and feasible for children in general pediatrics ward, and the prevention and treatment of complications should be strengthened.
【作者單位】： 復(fù)旦大學(xué)附屬兒科醫(yī)院;
【分類號(hào)】：R473.72
【正文快照】： 經(jīng)外周穿刺中心靜脈導(dǎo)管(PICC)作為中長(zhǎng)期輸液導(dǎo)管,在兒科領(lǐng)域多用于血液腫瘤科需要化療的患兒[1]和新生兒科外周靜脈穿刺困難、輸注胃腸外營(yíng)養(yǎng)(PN)、輸注刺激性藥物的患兒[2]。隨著兒科�？漆t(yī)院普通病房�？苹潭取⑽Ｖ貜�(fù)雜度越來越高,靜脈通路的建設(shè)日漸重要。但國內(nèi)由于主

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