摘要【目的】探讨腔内心电图定位技术在新生儿经外周静脉置入中心静脉导管(Peripherally inserted central catheter,PICC)置管时导管尖端定位中的应用效果及安全性。【方法】选择2020年1月至2021年12月在本院新生儿科接受PICC置管的100例新生儿,按照随机数字表法分为观察组和对照组,每组50例。对照组新生儿PICC置管时导管尖端定位中选择X线进行定位,观察组新生儿PICC置管时导管尖端定位中选择腔内心电图定位技术进行定位,比较两组新生儿的一次性尖端到位率、置管次数、置管时间、生命体征指标、并发症发生率及两组新生儿家长的疾病不确定感评分、不良情绪评分及满意度。【结果】与对照组比较,观察组新生儿的一次性尖端到位率更高(P<0.05),置管次数更少(P<0.05),置管时间更短(P<0.05)。置管后,对照组新生儿收缩压、舒张压、心率与置管前比较,差异有统计学有意义(P<0.05),而观察组新生儿收缩压、舒张压、心率与置管前比较,差异无统计学意义(P>0.05)。观察组新生儿并发症发生率显著低于对照组新生儿,差异有统计学意义(P<0.05)。与置管前比较,两组新生儿家长在置管后的疾病不确定感评分、焦虑评分、抑郁评分均明显降低(P<0.05);与对照组比较,观察组新生儿家长在新生儿置管后的疾病不确定感评分、焦虑评分、抑郁评分均明显降低(P<0.05)。观察组新生儿家长的总满意率高于对照组(P<0.05)。【结论】在新生儿PICC置管过程中,采用腔内心电图定位技术对导管尖端进行定位,可提高一次性尖端到位率,减少置管次数,缩短置管时间,还可维持置管时新生儿的生命体征稳定,降低并发症发生率,有利于减轻新生儿家长的不良情绪及不确定感,使其对PICC置管服务更加满意。
Abstract：【Objective】To explore the effect and safety of intracavitary electrocardiogram (ECG) positioning technology in positioning the tip of peripherally inserted central catheter (PICC) in newborns. 【Methods】From January 2020 to December 2021, 100 newborns who received PICC catheter in the neonatology department of our hospital were randomly divided into two groups according to the random number table method. There were 50 newborns in both observation group and control group. In the control group, X-ray was selected to locate the catheter tip during PICC catheter placement, while in the observation group, intracavitary electrocardiogram was selected to locate the catheter tip during PICC catheter placement. The one-time tip arrival rate, catheter placement times, catheter placement time, vital signs indicators, incidence of complications were compared between the two groups of newborns. The score of disease uncertainty, negative emotion score and parents' satisfaction of the two groups were compared as well. 【Results】Compared to the control group, the rate of one-time catheter tip placement in the observation group was higher (P<0.05), the times of catheterization of newborns in the observation group were significantly less (P<0.05), and the catheterization time in the observation group was significantly shorter (P<0.05). After catheterization, the systolic blood pressure, diastolic blood pressure and heart rate of newborns in the control group changed significantly compared with those before catheterization (P<0.05), while those in the observation group did not change significantly compared to before catheterization (P>0.05). The incidence of neonatal complications in observation group was lower than that in control group (P<0.05). Compared with before catheterization, the uncertainty score, anxiety score and depression score of neonatal parents in both groups after catheterization were significantly reduced (P<0.05). The scores of disease uncertainty, anxiety and depression of newborn's parents in the observation group after catheter placement were significantly lower than those in the control group(P<0.05). The total satisfaction rate of newborn's parents in the observation group was higher than that in the control group (P<0.05). 【Conclusion】Application of intracavitary ECG positioning technology to locate the catheter tip in the process of PICC catheter placement in newborns can improve the one-time tip delivery rate, reduce the number of catheterization times, shorten the catheterization time, maintain the stability of neonatal vital signs during catheterization, and reduce the incidence of complications. It also reduce the negative emotion and disease uncertainty of newborn's parents to make them more satisfied with PICC catheter placement service.
袁磊, 周晓阳, 龚洁, 沈阳, 黄亚芹, 刘璇, 程煜娟. 腔内心电图定位技术在新生儿PICC置管时导管尖端定位中的应用效果及安全性分析[J]. 医学临床研究, 2022, 39(9): 1378-1381.
YUAN Lei, ZHOU Xiao-yang, GONG Jie, et al. Study on Effect and Safety of Intracavitary Electrocardiographic Positioning Technology in Catheter Tip Localization of Neonatal PICC. JOURNAL OF CLINICAL RESEARCH, 2022, 39(9): 1378-1381.
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2022, Vol. 39 
