新生儿PICC导管相关并发症发生危险因素及护理对策

目的探讨新生儿经外周静脉置入中心静脉导管(PICC)相关并发症发生危险因素及护理对策。方法选取2019年2—10月就诊于我院的PICC置管新生儿128例,其中发生PICC导管并发症32例。统计PICC导管并发症类型,采用单因素和多因素logistic回归分析新生儿PICC导管相关并发症发生的危险因素。结果32例新生儿PICC导管相关并发症中,导管堵塞占比最高,其次为机械性静脉炎、导管异位、导管相关血流感染、导管断裂。经单因素分析,出生体质量<1500 g、外部未加固、导管尖端未到达预期位置、留置时间>15 d、连续输液是新生儿PICC导管相关并发症发生因素(P<0.05)。多因素logistic回归分析显示,出生体质量<1500 g、外部未加固、导管尖端未到达预期位置、留置时间>15 d、连续输液是新生儿PICC导管相关并发症发生的独立危险因素(P<0.05)。结论出生体质量<1500 g、外部未加固、导管尖端未到达预期位置、留置时间>15 d、连续输液是新生儿PICC导管相关并发症发生危险因素,需采用针对性护理干预措施,降低PICC导管相关并发症发生率。

Risk factors and nursing countermeasures of related complications in neonates with PICC catheter

Objective To explore the risk factors and nursing countermeasures of related complications in neonates with peripherally inserted central venous catheters(PICC)catheter.Methods To select 128 cases of neonates with PICC catheters who were admitted to our hospital from February to October 2019,among them,32 cases of patients had PICC catheter complications.The types of PICC catheter complications were counted,and univariate and multi-factor logistic regression were used to analyze the risk factors of neonatal PICC catheter-related complications.Results Among the 32 neonates with PICC catheter-related complications,catheter occlusion accounted for the highest proportion,followed by mechanical phlebitis,catheter ectopic,catheter-related bloodstream infection,and catheter was rupture.Univariate analysis showed that the birth weight<1500 g,unreinforced external,catheter tip did not reach the expected position,indwelling time>15 d,continuous infusion were the factors in neonates with PICC catheter related complications(P<0.05).Multivariate logistic regression analysis showed that the birth weight<1500 g,unreinforced external,catheter tip did not reach the expected position,indwelling time>15 d,continuous infusion were the independent risk factors in neonates with PICC catheter related complications(P<0.05).Conclusion The birth weight<1500 g,unreinforced external,catheter tip did not reach the expected position,indwelling time>15 d,continuous infusion were the risk factors in neonates with PICC catheter related complications.The targeted nursing interventions were needed to reduce the incidence rate of PICC catheter-related complications.