低出生体重儿胃肠外营养静脉通路的应用研究

目的 了解低出生体重儿胃肠外营养静脉通路使用现状,在保证医疗护理质量安全前提下,尽可能节约医疗成本,建立最适宜患儿和医护人员接受的低出生体重儿胃肠外营养静脉通路的途径.方法 对2012年1月～2012年6月在我院新生儿科入住并进行胃肠外营养液治疗的368例低出生体重患儿所使用的静脉通路（四肢浅静脉组、中心静脉组、腋静脉组）进行回顾性分析,同时分别对保留时间、三组患并发症发生率、医疗成本行对比性研究.结果 选择使用四肢浅静脉组156例（A组包括头皮静脉）42.4%、中心静脉组60例（B组：PICC,包括CVC）16.3%、腋静脉组152例（C组）41.3%;三组通道平均留置时间：A组2.5d,B组20d,C组7.5d,B组患儿静脉留置时间显著长于A组（P〈0.05）;三组通路所需耗材费用结果比较：B组＞A组＞C组;三组患儿静脉通路并发症发生率差异无统计学意义.结论 腋静脉通路能够满足患儿胃肠外静脉营养液治疗期间的需要,并发症发生率低,节约医疗成本,值得在新生儿科推广使用.

The applied research of parenteral nutrition venous channel for low birth weight infant

Objective To explore the most suitable method of parenteral nutrition venous channel by investigating the present situation of parenteral nutrition veinous channel in low birth weight, which can be accepted by patients and medical staff, as far as saving medical costs, with guaranteed quality and safety of medical care. Methods Totally 368 low birth weight infants from January to June,2012 with parenteral nutrition therapy in the department of Neonatology were divided into three groups. The group A was conducted with superficial venous indwelling needle in the four limbs or scalp,while the group B was conducted with central venous indwelling needle and the group C was conducted with axillary venous indwelling needle~ The retention time, the medical costs and the complication rate were compared among the three groups. The data of the cases were analyzed retrospectively. Results There were 156 cases in group A（42.4% ） ,60 cases in group B（ 16. 3% ） ,152 cases in group C（41.3% ）. The average retention time ： group A was 2. 5 days, group B was 20 days, group C was 7.5 days. The retention time in group B was significantly longer than those in groups A （ P 〈 0. 05 ） ; the medical cost： group B 〉 group A 〉 group C ; there were no significant difference on the complication rate. Conclusion Axillary venous channel could not only satisfy the low birth weight infants with parenteral nutrient treatment, but also have low complication rate and save medical costs, it should be used in the department of Neonatology.