背景:在新生儿重症监护病房中,通常使用外周插入的中心导管(PICC)进行延长的静脉营养和治疗。PICCs插入位点的选择可以显著影响插入结果和新生儿安全。
目的:本研究旨在确定新生儿PICCs下肢最适合的插入部位。
方法:对一所大学教学医院的40张病床的三级新生儿重症监护病房中通过下肢(LE)部位插入的PICC进行了回顾性病例回顾。出于研究目的访问数据的日期为2019年6月至2022年6月。总的来说,223例新生儿被确定为患有PICC,254根导管插入下肢。STROBE检查表指导了本研究的报告。
结果:新生儿通过LE静脉插入PICC,总体并发症发生率为13.4%,一次穿刺成功率为86.2%。并发症的发生率,导管闭塞,经大隐静脉插入PICC组的导管相关性感染明显低于股静脉组(p<0.05)。成功率明显高于股静脉组(p<0.05)。此外,通过右侧LE插入PICC的总并发症和导管闭塞并发症的发生率明显低于通过左侧LE插入的总并发症和导管闭塞并发症的发生率(p<.05).
结论:我们的研究表明,在可行的情况下,右侧LE的隐静脉可能是最适合新生儿PICCs的插入部位.
结论:这些发现提供了对并发症的见解,留置时间,以及不同LE部位新生儿PICC的安全性,为临床实践提供有价值的参考。这项研究是回顾性的,所有相关人员都获得了患者临床数据的批准。经湘雅医院伦理委员会批准,中南大学(登记号2022010001)。
BACKGROUND: Peripherally inserted central catheters (PICCs) are commonly used in neonatal intensive care units for extended intravenous nutrition and therapy. The selection of PICCs insertion sites can significantly influence insertion outcomes and neonatal safety.
OBJECTIVE: This study aimed to determine the most suitable insertion site in the lower extremities for neonatal PICCs.
METHODS: A retrospective case note review was conducted on PICCs inserted through lower extremity (LE) sites in a 40-bed tertiary-level neonatal intensive care unit at a university teaching hospital. The dates when data were accessed for research purposes were from June 2019 to June 2022. In total, 223 neonates were identified as having had PICCs, with 254 catheters inserted in the lower extremities. The STROBE checklist guided the reporting of this study.
RESULTS: Neonates underwent PICC insertion via the LE vein, with an overall complication rate of 13.4% and a one-attempt success rate of puncture of 86.2%. The rates of complications, catheter occlusion, and catheter-related infection in the PICC group with insertion through the great saphenous vein were significantly lower than those in the femoral vein group (p < .05). The success rate was significantly higher than that in the femoral vein group (p < .05). Additionally, the incidence of total complications and catheter occlusion complications with PICC insertion via the right LE was significantly lower than that with insertion via the left LE (p < .05).
CONCLUSIONS: Our study suggested that, when feasible, the saphenous vein in the right LE could be the most suitable insertion site for neonatal PICCs.
CONCLUSIONS: These findings provide insights into the complications, indwelling time, and safety of neonatal PICCs in different LE sites, serving as a valuable reference for clinical practice. This study was retrospective in nature, and all staff involved obtained approved access to patient clinical data. Ethical approval was granted by the Ethics Committee of Xiangya Hospital, Central South University (registry number 2022010001).