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[心电图监测仪在新生儿经外周静脉穿刺中心静脉置管中导管尖端定位的有效性]

[Efficiency of electrocardiogram monitor for positioning the catheter tip in peripherally inserted central catheter placement in neonates].

作者信息

Ling Qi-Ying, Chen Hong, Tang Min, Qu Yi, Tang Bin-Zhi

机构信息

Department of Pediatrics, Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital/University of Electronic Science and Technology of China, Chengdu 610072, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2018 May;20(5):363-367. doi: 10.7499/j.issn.1008-8830.2018.05.005.

Abstract

OBJECTIVE

To study the efficiency of electrocardiogram (ECG) monitor for positioning the catheter tip in the placement of peripherally inserted central catheter (PICC) in neonates.

METHODS

A total of 160 neonates who were admitted to the neonatal intensive care unit (NICU) from January 2015 to December 2017 and underwent the PICC placement via the veins of upper extremity were enrolled. They were randomly divided into an observation group and a control group, with 80 neonates in each group. The neonates in the control group were given body surface measurement and postoperative X-ray localization, while those in the observation group were given body surface measurement, ECG localization, and postoperative X-ray localization. The two groups were compared in terms of general information, one-time success rate of PICC placement, and time spent on PICC placement.

RESULTS

There were no significant differences between the two groups in sex composition, gestational age, age in days at the time of PICC placement, disease type, and site of puncture (P>0.05). Compared with the control group, the observation group had a significantly higher one-time success rate of PICC placement (95% vs 79%; P<0.05) and a significantly shorter time spent on PICC placement (P<0.05). Localization under an ECG monitor during PICC placement had a sensitivity of 97% and a specificity of 100%.

CONCLUSIONS

During the PICC placement in neonates, the use of ECG monitor to determine the position of catheter tip can improve the one-time success rate of placement and reduce the time spent on placement.

摘要

目的

研究心电图(ECG)监测仪在新生儿经外周静脉穿刺中心静脉置管(PICC)时用于导管尖端定位的效果。

方法

选取2015年1月至2017年12月入住新生儿重症监护病房(NICU)并经上肢静脉行PICC置管的160例新生儿。将其随机分为观察组和对照组,每组80例。对照组新生儿采用体表测量及术后X线定位,观察组新生儿采用体表测量、心电图定位及术后X线定位。比较两组的一般资料、PICC置管一次性成功率及PICC置管所用时间。

结果

两组在性别构成、胎龄、PICC置管时日龄、疾病类型及穿刺部位方面比较,差异均无统计学意义(P>0.05)。与对照组比较,观察组PICC置管一次性成功率明显更高(95%对79%;P<0.05),且PICC置管所用时间明显更短(P<0.05)。PICC置管时心电图监测仪定位的灵敏度为97%,特异度为100%。

结论

在新生儿PICC置管过程中,使用心电图监测仪确定导管尖端位置可提高置管一次性成功率并缩短置管时间。

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