新生儿脐静脉置管术后管尖异位及并发症的超声表现

目的分析脐静脉置管(UVC)术后导管异位及并发症的超声图像表现。方法对我院新生儿科144例行UVC的新生儿术后行动态床旁彩超检查,记录发生置管后异位及并发症的超声图像,并随访。结果UVC导管异位发生率是65例(45.14%),其中导管进入肝脏门静脉者5例(3.47%),导管进入肝实质者4例(2.78%),导管管尖进入右心房56例(38.89%);并发症的发生率是22例(15.28%),其中肝脏实质损伤9例(6.25%),导管相关性血栓12例(8.33%),1例(0.69%)心包积液。结论新生儿UVC后要警惕导管管尖异位及并发症。床旁超声的动态监测可以及早发现管尖异位及并发症,值得在新生儿病房推广应用。

Malposition And Complications of Umbilical Vascular Catheters In The Neonatal Period,the Sonographic Features

Objective To analysis the sonographic features of malposition and umbilical vascular catheter-related complications.Methods Bedside sonographic examination of 144 newborn infants with umbilical vascular catheterization was conducted to obtain the sonographic image of malposition of umbilical vascular catheter tip and umbilical catheter-related complications.Results The umbilical vascular catheter tip malposition rate was 45.14%(65 cases):the umbilical vascular catheter tip of 5 cases(3.47%)were within portal vein,4 cases(2.78%)were within the liver parenchyma,and 56 cases(38.89%)were within right atrium.Umbilical catheter-related complications were seen in 22 cases(15.28%)of patients.The frequency of liver-related complications from umbilical venous catheterization was6.25%(9 cases),catheter-related thrombosis was noted in 8.33%(12 cases),and the frequency of pericardial effusion was 0.69%(1 case).Conclusions The umbilical vascular catheter tip malposition and umbilical catheter-related complications in newborn infants with umbilical vascular catheterization should been cause for concern.Bedside ultrasound can be used in the early detection of umbilical vascular catheter tip malposition and umbilical catheter-related complications,and it would be worth of adoption and promotion in neonate ward.