地塞米松联合喜辽妥预防早产儿PICC机械性静脉炎效果观察

目的探讨地塞米松溶液浸泡PICC导管联合喜辽妥外涂护理预防超低、极低出生体重早产儿PICC置管后机械性静脉炎的效果。方法将2012年1月²013年5月NICU住院行PICC置管的超低、极低出生体重早产儿133例,分为3组,联合组45例,地塞米松组44例,对照组44例。联合组在置管前用生理盐水(NS)10 ml+地塞米松5 mg配制成的液体浸泡PICC导管5 min后进行置管,置管后从静脉穿刺点上方32013年5月NICU住院行PICC置管的超低、极低出生体重早产儿133例,分为3组,联合组45例,地塞米松组44例,对照组44例。联合组在置管前用生理盐水(NS)10 ml+地塞米松5 mg配制成的液体浸泡PICC导管5 min后进行置管,置管后从静脉穿刺点上方3⁴ cm处沿血管走向连续7 d预防性涂敷喜辽妥;地塞米松组在置管前用NS 10 ml+地塞米松5 mg配制成的液体浸泡PICC导管5 min后进行置管,置管后不涂喜辽妥;对照组用生理盐水浸泡PICC导管5 min后进行置管,置管后不涂喜辽妥,观察3组机械性静脉炎的发生率。结果联合组发生静脉炎2例,地塞米松组发生静脉炎7例,对照组发生静脉炎16例,3组比较差异有统计学意义(p<0.05)。结论超低、极低出生体重早产儿PICC置管前用地塞米松溶液浸泡PICC导管,置管后预防性使用喜辽妥涂敷可有效降低早产儿PICC机械性静脉炎的发生率。

CLINICAL EFFECT OF DEXAMETHASOME AND HIRUDOID CREAM ON PREVENTION OF PICC-INDUCED MECHANICAL PHLEBITIS IN PRETERM INFANT

Objective To study the effects of the dexamethasone solution soaking catheter and Hirudoid Cream apply on prevention of mechanical phlebitis induced by peripherally inserted central catheter （PICC） in extreme low birth weight（ELBW） and very low birth weight （VLBW）infants. Methods 133 patients with PICC were randomized into 3 groups ： dexamethasone treatment group （44 cases）, combination treatment group （ 45 cases ） and control group（44cases）. The catheter was soaked in dexamethasone solution（5 mg DMX in 10 ml 0. 9% NaCl） for 5 mins before catheterization in the dexamethasone group. The combination treatment group was treated with dexamethasone soaking before catheterization and external hirudoid cream application after catherization for 7 days. The control group was given usual management. The three groups were compared in the incidence of phlebitis. Results 7 cases occurred mechanical phlebitis in the dexamethasone group, and 2 cases occurred in the combination treatment group, while 16 cases in the control group. Compared with the control group and the dexamathasone group, the incidence of phlebitis in combination treatment group was decreased significantly （p 〈 0. 05 ）. Conclusion The data showed that treament with dexamethasone and hirudoid cream could prevent mechanical phlebitis caused by PICC catheterization in premature infants.