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PICC在重症新生儿肠外营养中的应用

Application of Peripherally Inserted Central Catheter for Parenteral Nutrition in Critically Ill Neonates

  • 摘要: 【摘要】 目的 探讨经外周静脉穿刺置入中心静脉导管(PICC)在长期需要肠外营养支持的危重新生儿中的应用。方法 对2011年3~12月需长期肠外营养支持的98例危重新生儿的PICC临床资料进行回顾性分析。结果 98例危重新生儿均成功置入PICC,一次穿刺成功率为74.5%(73/98),导管留置时间(19.7±2.0) d,成功过渡到肠内营养完全建立并成功拔管的92例(93.9%),发生并发症共10例,发生率为10.5/1000导管日,其中感染0例,静脉炎1例,导管脱落3例,导管堵塞3例,穿刺点渗血3例。因并发症拔管6例,采取对症治疗后继续PICC治疗4例。结论 PICC可作为需要长期肠外营养支持的危重新生儿的静脉通路,掌握正确的PICC方法,可减少相关并发症的发生。

     

    Abstract: 【Abstract】 Objective To apply peripherally inserted central catheter (PICC) in critically ill neonates who require long-term parenteral nutrition. Methods A retrospective review of 98 critically ill neonates who had a PICC inserted and received long-term parenteral nutrition from March to December 2011 was performed. Results The PICC insertion succeeded in 74.5% (73/98) of the cases at the first attempt. The catheter remained for an average of (19.7±2.0) days. Of the 98 cases, 92 underwent planned extubation after enteral nutrition was fully established; 10 developed complications within the follow-up period of 956 days. The PICC-associated complications occurred at a rate of 10.5 per 1000 catheter-days, including infection (n=0), phlebitis (n=1), accidental dislodgement (n=3), catheter occlusion (n=3), and hemorrhage in puncture point (n=3). Conclusion PICC can be used as a safe venous access for critically ill neonates for long-term parenteral nutrition. PICC-associated complications can be reduced through improving nursing skills, especially for catheter-related infection.

     

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