意外伤害患儿上腔静脉置入20 cm中长导管的效果观察

doi:10.16460/j.issn1008-9969.2020.16.052

摘要/Abstract

摘要： 目的探讨1~3周岁意外伤害患儿上腔静脉置入20 cm中长导管的应用效果。方法选取某三级甲等医院1~3周岁意外伤害患儿为研究对象,2016年1月—2017年12月置入PICC意外伤害患儿为对照组,2018年1月—2019年10月采用20 cm中长导管置管的意外伤害患儿为观察组。对照组采用PICC导管,观察组采用20 cm中长导管,比较2组意外伤害患儿置管总费用、导管末端位置准确率、导管留置时间、置管后并发症发生率。结果 20 cm中长导管置入上腔静脉费用（752元）较PICC导管费用（1 953元）低;2组患儿导管末端到达理想位置（上腔静脉下1/3）情况比较,差异无统计学意义（P>0.05）;2组患儿导管留置时间和并发症发生率比较,差异无统计学意义（P>0.05）。结论 20 cm中长导管置入上腔静脉能够为1~3周岁意外伤害患儿提供安全、有效的静脉输液通路,同时较PICC置管相比,可降低患儿的置管费用,置入上腔静脉达理想位置与PICC导管相同,其留置时间与PICC导管相当,满足患儿治疗需要,不增加并发症发生,安全可行,值得临床借鉴使用。

关键词: 中长导管, PICC, 幼儿, 意外伤害

Abstract: Objective To investigate the efficacy of 20cm midline catheter placement in superior vena cava in toddlers with unintentional injury. Methods Cases of toddlers with unintentional injury and received peripherally inserted central catheter (PICC)from January 2016 to December 2017 in a tertiary grade-A hospital were taken as control group and those who received 20 cm midline catheter from January 2018 to October 2019 were selected as intervention group.The control group was treated with traditional PICC catheterization, and the intervention group with a 20cm midline catheter into the superior vena cava. Then the total cost of catheterization, the accuracy of catheter end position, catheter indwelling time, and the incidence of complications after catheterization were compared between the two groups. Result The cost of 20cm midline catheterization of superior vena cava (752 yuan) was lower than that of PICC catheterization (1,953 yuan). There was no significant difference between the two groups when the end of the catheter reached the ideal position (1/3 of the superior vena cava)(P>0.05). There was no significant difference in catheter indwelling time and complication rate between the two groups (P>0.05). Conclusion The insertion of 20cm midline catheter into the superior vena cava can provide safe and effective intravenous infusion access for toddler with unintentional injury. Compared with PICC catheterization, it can significantly reduce the catheterization cost, and it is worthy of further promotion in clinical practice.

Key words: midline catheter, peripherally inserted central catheter, toddler, unintentional injury

中图分类号:

R472.9

李兰, 李现文, 蔡志云, 黄珑玲, 韩秋英. 意外伤害患儿上腔静脉置入20 cm中长导管的效果观察[J]. 护理学报, 2020, 27(16): 52-55.

LI Lan, LI Xian-wen, CAI Zhi-yun, HUANG Ling-long, HAN Qiu-ying. Effect of Inserting 20cm Midline Catheter into Superior Vena Cava in Children with Accidental Injury[J]. Journal of Nursing, 2020, 27(16): 52-55.

参考文献

[1] 莫庆仪,黄东明,谢广清,等.儿童意外伤害924例分析[J].中国当代儿科杂志,2013, 15(7):559-562.DOI:10.7499 /j.issn.1008-8830.2013.07.013.
[2] 韩琨,项骁,王旸,等.北京市7334例住院儿童意外伤害流行病学特征分析[J].中华疾病控制杂志,2015,19(5):431-434. DOI:10.16462/j.cnki.zhjbkz.2015.05.001.
[3] 余卓文,顾莺,张玉侠,等.经外周穿刺中心静脉导管在普通儿科病房中长期输液患儿应用的可行性研究[J].中国循证儿科杂志,2017,12(2):100-105.DOI:10.3969 /j.issn.1673-5501.2017.01.004.
[4] 卫生部卫生统计信息中心,北京协和医院世界卫生组织疾病分类中心.国际疾病分类(ICD-10)[M].北京:中国协和医科大学出版社,2001:820-822.
[5] 余琪. 婴幼儿PICC置管长度测量方法的改进[J].护理研究,2016, 30(7):2559-2560.DOI:10.3969/j.issn.1009-6493.2016.20.048.
[6] 谌永毅,李旭英.血管通道护理技术[M].北京:人民卫生出版社,2015:125.
[7] 李兰,蔡志云,郑俊艺,等.超声引导下2次改良塞丁格技术在中线导管中的应用效果观察[J].护理学报,2018,25(20):57-60. DOI:10.16460/j.issn.1008-9969.2018.20.00.
[8] 陈珺,管萍,何梦雪,等.经股静脉中段留置PICC在婴幼儿困难静脉通路的应用[J].护理学杂志,2019,34(15):9-13. DOI:10.3870 /j.issn.1001-4152.2019.15.009.
[9] Oliver G, Jones M.ECG or X-ray as the ‘Gold Standard' for Establishing PICC-Tip Location?[J]. Br J Nurs, 2014,23(19):S10.
[10] 刘倩,赵兴扬,王春梅.定位PICC头端位置的影像学标志可靠性探讨[J].山东医药, 2011,51(20):71-73.
[11] 吴玉芬,杨巧芳.静脉输液治疗专科护士培训教材[M].北京:人民卫生出版社,2018:295.
[12] Pittiruti M,Emoli A,Porta P,et al.A Prospective,Randomized Comparison of Three Different Types of Valved and Non-valved Peripherally Inserted Central Catheters[J]. J Vase Access,2014,15(6):519-523.
[13] Gorski L A.The 2016 Inufusion Therapy Standards of Practice[J].Home Healthc Now,2017,35(1):10-18.
[14] 国务院. 国务院关于印发“十三五”卫生与健康规划的通知[EB/OL]. [2019-01-15]. http://www.gov.cn/zhengce/content/2017-01/10/content_5158488.htm.
[15] 余琪,曾铁英,冯丽娟,等.婴幼儿PICC左上肢置入体外测量法改进[J].护理学杂志,2017,32(6):47-49. DOI:10.3870/j.issn.1001-4152.2017.06.047.
[16] 崔焱. 儿科护理学[M].6版.北京:人民卫生出版社,2018.
[17] 王玉红. 石家庄地区3-6岁儿童体型分析及服装结构研究[D].石家庄:河北科技大学,2012.
[18] Infusion Nurses Society.Infusion Therapy Standards of Practice[J].J Infus Nurs,2016,39(1s):39-95.DOI:10.1097/NHH.0000000000000481.
[19] 李晨晨,胡明,褚珺,等.外周穿刺中心静脉导管与完全植入式静脉输液港在儿童肿瘤的临床比较[J].介入放射学杂志,2018,27(8):735-739.

相关文章 15

[1]	张月葵, 罗春绸, 林英, 林秀梅, 张小双, 陈雅玲. 改良经鼻吸痰法降低婴幼儿鼻黏膜出血的效果观察[J]. 护理学报, 2020, 27(8): 62-64.
[2]	樊艳华, 邬要芬, 幸敏清. PICC带管出院患者基于ADOPT模式健康教育的效果观察[J]. 护理学报, 2020, 27(8): 73-76.
[3]	李嫒, 庞艳, 林芳初, 涂素华. 婴幼儿顺应喂养的研究进展[J]. 护理学报, 2020, 27(7): 34-37.
[4]	谭凤秀, 梁彩云, 何丽和, 莫月娥. 心内心电图特异性Q波辅助PICC尖端定位的效果观察[J]. 护理学报, 2020, 27(7): 58-60.
[5]	王佳, 郝飞, 周慧敏. 叠加敷料粘贴法对乳腺癌患者PICC置管部位接触性皮炎的效果观察[J]. 护理学报, 2020, 27(4): 63-66.
[6]	徐绍莲, 臧谋红, 唐瑭, 霍丽萍, 朱贞祥. 肿瘤化疗患者植入式静脉输液港与PICC并发症发生情况Meta分析[J]. 护理学报, 2020, 27(3): 37-42.
[7]	谷小燕, 杨金芳, 谢华琴, 张亚琼. 癌症患者行超声引导改良塞丁格技术经锁骨下静脉置PICC导管的对照研究[J]. 护理学报, 2020, 27(13): 70-74.
[8]	何华, 刘利, 杨靖, 张阳阳, 王黎红, 张亚妮, 康国华, 张敏. 改良移除和粘贴敷贴方法预防PICC患者医用粘胶相关性皮肤损伤的效果观察[J]. 护理学报, 2019, 26(7): 61-64.
[9]	卞伶玲, 杨金娜, 赵益, 杨雨佳. 双腔Power PICC置管部位医用粘胶剂相关性皮肤损伤的风险预防管理[J]. 护理学报, 2019, 26(6): 64-66.
[10]	许建芬, 陈正香, 葛兆霞. 旋腕运动预防PICC术后静脉血栓形成的效果观察[J]. 护理学报, 2019, 26(5): 66-68.
[11]	武艳, 徐琴, 周春苗, 董娟, 胡思萍, 袁昌平. 婴幼儿经鼻气管插管护理质量评价指标体系的构建[J]. 护理学报, 2019, 26(23): 25-28.
[12]	朱芳, 邱赛男, 苏斯, 方婷. 上挑扩皮技术在心电定位辅助超声引导下PICC置管中的应用效果[J]. 护理学报, 2019, 26(23): 69-70.
[13]	李钱玲, 甘秀妮, 李源, 唐玮. Autar量表与Caprini评估模型对肿瘤患者PICC相关静脉血栓形成预测效果的对比研究[J]. 护理学报, 2019, 26(22): 1-5.
[14]	李晓芳, 李育玲, 于静. PICC带管出院患者护理敏感性结局指标体系的构建[J]. 护理学报, 2019, 26(20): 5-10.
[15]	李兰, 蔡志云, 彭健, 林玉凤, 韩秋英. 生理盐水联合无导针器技术在超声引导改良塞丁格PICC置管术中的效果观察[J]. 护理学报, 2019, 26(20): 59-62.

Metrics

Viewed

Full text

Abstract

Cited

Shared