重症监护室患儿中心静脉导管穿刺口渗血的影响因素分析

目的探讨儿童重症监护室患儿中心静脉导管穿刺口渗血发生情况及其影响因素。方法对广州某三级甲等医院儿童重症监护室2012年11月—2013年11月留置中心静脉导管364例患儿413例次导管穿刺点情况,进行观察和记录并收集相关临床资料,进行统计分析。结果穿刺口渗血的176(42.6%)例次,其中轻中度出血164例次,重度出血12例次;穿刺后24 h内渗血29(7.2%)例次;开始出现渗血时间为(4.19±2.95)d;中心静脉导管固定缝线的脱落、导管移位、管道留置时间4 d是穿刺口渗血的危险因素,患儿年龄3岁是保护因素。结论患儿的年龄、管道留置时间、中心静脉导管固定是中心静脉导管留置过程中穿刺口渗血重要影响因素。

Influence Factors of Insertion Site Errhysis of Central Venous Catheter in Pediatric Intensive Care Unit

Objective To explore the incidence and influence factors of insertion site errhysis of central venous catheter in pediatric intensive care unit. Methods A prospective study was undertaken from November 2012 to November 2013 of 413 central venous catheterizations in 364 children in a pediatric intensive care unit on a third-level first-class hospital in Guangzhou. Results Insertion site errhysis occurred in 176 cases （42.6%） with 164 cases of mild to moderate bleeding and 12 cases of severe bleeding and 29 （7.2%） began to bleeding within 24 hours after the puncture and the average time of errhysis occurrence was （4.19 ±2.95） days. CVC fixed-stitches-off, displacement, the duration of catheterization （ longer than 4 days） were risk factors of errhysis but age（3 years above） was a protective factor. Conclusion Patients’ age, the duration of catheterization and CVC-fixing are important influence factors of insertion site errhysis of central venous catheter during catheter maintenance.