摘要
目的探讨脐静脉置管在新生儿中的应用。方法连续性选取北京大学第三医院新生儿重症监护病房2007年11月至2019年9月行脐静脉置管的病例,收集临床病历资料,分析脐静脉置管在新生儿中的应用时间、置管相关性血流感染的发生率、病原菌及拔管原因。结果共入选新生儿835例,其中男435例(52.1%),女400例(47.9%),平均胎龄(30.6±2.4)周,中位出生体重1310(1080,1520)g。脐静脉置管平均留置时间(4.850±1.893)d。10例(1.2%)新生儿发生置管相关性血流感染,病原菌主要为表皮葡萄球菌、沃氏葡萄球菌、溶血葡萄球菌、屎肠球菌。共770例(92.2%)新生儿进行计划内拔管,非计划拔管65例(7.8%),非计划拔管前3位原因为脐轮红肿、临床诊断败血症、置管相关性血流感染及堵管。结论脐静脉置管操作简单,成功率高,安全性高,在新生儿重症监护病房中可以短期应用。如有条件,需监测腹部B超、超声心动图等,注意置管相关并发症。
Objective To investigate the application of umbilical vein catheterization in neonates.Methods The patients who underwent umbilical vein catheterization from November 2007 to September 2019 in neonatal intensive care unit(NICU)at Peking University Third Hospital were selected consecutively.Clinical data were collected retrospectively to investigate the application time of umbilical vein catheterization in neonates,the incidence of catheter-related bloodstream infection,pathogenic bacteria and the causes of extubation.Results A total of 835 newborns were enrolled,including 435 males(52.1%)and 400 females(47.9%).The average gestational age was(30.6±2.4)weeks.The median birth weight was 1310(1080,1520)g.The average indwelling time of umbilical vein catheterization was(4.850±1.893)days.Catheter related bloodstream infection occurred in ten(1.2%)neonates.The main pathogens were Staphylococcus epidermidis,Staphylococcus wallichi,Staphylococcus haemolyticus and Enterococcus faecium.A total of 770(92.2%)newborns were extubated in a planned manner,and 65(7.8%)were unplanned extubation.The top three causes of unplanned extubation were umbilical wheel swelling,clinical diagnosis of sepsis,catheter-related bloodstream infection and tube blockage.Conclusion Umbilical vein catheterization is simple,high success rate,safe and can be used in NICU for a short time.If possible,abdominal B-ultrasound and echocardiography should be monitored and catheter related complications should be noted.
作者
王晴晴
杨雨怡
朴梅花
韩彤妍
Wang Qingqing;Yang Yuyi;Piao Meihua;Han Tongyan(Department of Pediatrics,Peking University Third Hospital,Beijing 100191,China)
出处
《中国小儿急救医学》
CAS
2021年第2期141-144,共4页
Chinese Pediatric Emergency Medicine
关键词
脐静脉置管
新生儿
置管相关性血流感染
拔管
Umbilical vein catheterization
Neonates
Catheter-related bloodstream infection
Extubation
作者简介
通信作者:韩彤妍,Email:tongyanhan@qq.com。
