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新生儿脐静脉导管并发症:一项为期6年的单中心经验

Umbilical venous catheter complications in newborns: a 6-year single-center experience.

作者信息

Mutlu Mehmet, Aslan Yakup, Kul Sibel, Yılmaz Gürdal

机构信息

a Division of Neonatology , Department of Pediatrics, Karadeniz Technical University , Trabzon , Turkey .

b Department of Radiology , Karadeniz Technical University , Trabzon , Turkey , and.

出版信息

J Matern Fetal Neonatal Med. 2016 Sep;29(17):2817-22. doi: 10.3109/14767058.2015.1105952. Epub 2015 Nov 2.

Abstract

OBJECTIVE

Umbilical venous catheter (UVC) insertion is frequently performed in critically ill neonates. Various mild or serious complications of umbilical venous catheterization can be observed associated with this procedure. In this study, newborns that have undergone UVC and developed complications were evaluated.

METHODS

This retrospective observational study was carried out in newborns that have undergone UVC and developed complications were evaluated between June 2008 and November 2014.

RESULTS

Umbilical venous catheter were inserted to 974 (22.4%) newborn and followed for 7402/catheter days. UVC-related complications developed at 198 patients (20.3%). The most common UVC-related complications were malposition (n = 189), catheter-related bloodstream infection (n = 6) and remnant of catheter in the umbilicus (n = 3), respectively. Remnant of catheter in the umbilicus was removed by pediatric surgeon. Except one patient, all patients were discharged.

CONCLUSION

Although UVC is a common and easy vascular access, this process is not without complications. UVC may be inappropriate position because the catheter is inserted by the pediatrician without imaging guidance and may occasionally be associated with complications. Inappropriate positioning of the catheter may observe during the follow-up and maintained care. Therefore, newborns particularly in premature and very low birth-weight newborn should be followed in terms of catheter complications during insertion, following and just after removing of the catheter.

摘要

目的

脐静脉导管(UVC)插入术在危重新生儿中经常进行。脐静脉导管插入术可观察到各种轻度或严重的并发症。在本研究中,对接受UVC并出现并发症的新生儿进行了评估。

方法

本回顾性观察研究在2008年6月至2014年11月期间对接受UVC并出现并发症的新生儿进行。

结果

对974例(22.4%)新生儿插入了脐静脉导管,共随访7402导管日。198例患者(20.3%)发生了与UVC相关的并发症。最常见的与UVC相关的并发症分别为位置不当(n = 189)、导管相关血流感染(n = 6)和脐部导管残留(n = 3)。脐部导管残留由小儿外科医生取出。除1例患者外,所有患者均出院。

结论

尽管UVC是一种常见且简便的血管通路,但该操作并非没有并发症。由于导管由儿科医生在无影像学引导下插入,UVC可能位置不当,且偶尔会伴有并发症。在随访和持续护理期间可能会观察到导管位置不当。因此,对于新生儿,尤其是早产儿和极低出生体重儿,在导管插入、随访及拔除后应密切关注导管并发症。

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