早产儿PICC导管最佳置入长度与体重的相关性

目的 分析早产儿经外周中心静脉置管(PICC)导管最佳置入长度与体重的相关性。 方法 回顾性分析2018年5月—2019年5月在浙江萧山医院新生儿重症监护室行PICC置管的150例早产儿临床资料,患儿置管24 h内均经胸片拍摄确定导管尖端位置、测量胸片上PICC导管最佳置入长度,并获取置管当日体重数据,对患儿PICC置管情况及置管静脉分布进行描述,通过Pearson相关性分析、一元线性回归分析探究不同置管静脉最佳置入长度与体重的相关性。 结果 150例早产儿中,有89例(59.33%) PICC置管导管尖端达到最佳位置,28例(18.67%)导管置入过深,12例(8.00%)导管置入过浅,21例(14.00%)导管路径异常;其中贵要静脉最佳位置到位率最高(66.22%),贵要静脉置入过深发生率也最高(22.97%),大隐静脉置入过浅发生率最高(20.00%),头静脉路径异常发生率最高(32.00%);Pearson相关性分析显示,早产儿PICC不同置管静脉导管最佳置入长度和体重均呈正相关(均P<0.05);一元线性回归分析结果显示,早产儿PICC不同置管静脉最佳置入长度与体重均有一定线性关系(均P<0.05)。 结论 早产儿PICC导管异位发生率较高,且在不同置管静脉中异位情况分布有一定差异,临床应结合早产儿具体情况选择合理置管静脉;早产儿PICC导管最佳置入长度与体重相关,可以用来指导PICC置管,但具体回归方程有待临床进一步校验。 

Correlation between optimal placement length of PICC catheter and body weight of preterm infants

Objective To analyze the correlation between optimal catheter placement length of peripherally inserted central catheter(PICC) and body weight of preterm infants. Methods The clinical data of 150 preterm infants who underwent PICC catheterization in the neonatal intensive care unit of the hospital from May 2018 to May 2019 were retrospectively analyzed. The position of catheter tip was measured by chest radiography and the optimal placement length of PICC catheter on chest radiograph was obtained within 24 h of catheterization, and the weight data on the day of catheterization was obtained. The PICC catheterization and catheter vein distribution were described. Pearson correlation analysis and unitary linear regression analysis were used to explore the correlation between optimal placement length of different catheterization veins and body weight. Results Of the 150 preterm infants, there were 89 cases(59.33%) with PICC catheter tip reaching the optimal position, 28 cases(18.67%) with catheter placed too deep, 12 cases(8.00%) with catheter placed too shallow and 21 cases(14.00%) with abnormal catheter pathway. The arrival rate of optimal position of basilic vein was the highest(66.22%), and the incidence rate of deep placement of basilic vein was also the highest(22.97%), and the incidence rate of shallow placement of great saphenous vein was the highest(20.00%), and the incidence rate of abnormal pathway of cephalic vein was the highest(32.00%). Pearson correlation analysis showed that there was a positive correlation between optimal placement length and body weight of different PICC catheterization veins in preterm infants(all P<0.05). Unitary linear regression analysis showed that there was a linear relationship between the optimal placement length and body weight of different PICC catheterization veins in preterm infants(all P<0.05). Conclusion The incidence rate of PICC catheter ectopy is higher in preterm infants, and there are some differences in the distribution of ectopic conditions in different catheterization veins. Clinically, the appropriate catheterization veins should be selected in combination with the specific circumstance of preterm infants. The optimal placement length of PICC catheter in preterm infants has a certain correlation with body weight and can be used to guide PICC catheterization, but the specific regression equation is subject to further clinical validation.