Lim Soo Ting Joyce, Hui Yuen Ching Angela, Lim Pei Kwee, Lim Chin Choo Evelyn, Yen Chia Yen, Vasanwala Rashida Farhad
Division of Nursing, Speciality Care Service, KK Women's and Children's Hospital, Singapore.
Division of Nursing, KK Women's and Children's Hospital, Singapore.
J Clin Transl Endocrinol. 2018 Apr 25;12:26-35. doi: 10.1016/j.jcte.2018.04.004. eCollection 2018 Jun.
To measure skin thickness (ST) and skin + subcutaneous layer thickness (SCT) by ultrasound and estimate the risk of intramuscular injection (IM) with different needle lengths across injection sites according to age group.
Children recruited between 1 and 18 years with type 1 and 2 diabetes on insulin injections and divided into three age groups: 1-6 years, 7-12 years and 13-18 years. A portable ultrasound was used to measure ST and SCT at four injection sites on the abdomen, arm, thigh and buttock.
Total 153 children enrolled for the study. The mean (SD) measurement of ST & SCT at four sites on abdomen, arm, thigh & buttocks were as follows; 4.33 mm (±2.22), 5.55 mm (±2.26), 5.83 mm (±3.12), 6.48 mm (±3.47) in 1-6 years old; 7.11 mm (±3.68), 7.79 mm (±4.54), 7.17 mm (±3.62), 8.51 mm (±3.65) in 7-12 years old; 8.94 mm (±4.50), 8.42 mm (±5.00), 8.61 mm (±4.76), 9.76 mm (±4.38) in 13-18 years old. Young children, 1-6 years have the highest risk of IM injection with all needle lengths, i.e. 4, 5, 6, 8 & 12.7 mm, while older children 7-12 & 13-18 years have a lower risk with shorter needles (4, 5 and 6 mm) as compared to longer needles (8 and 12.7 mm).
Children with diabetes on insulin therapy should be advised on the appropriate needle length accordingly to their age and BMI.
通过超声测量皮肤厚度（ST）和皮肤+皮下层厚度（SCT），并根据年龄组评估不同针长在不同注射部位进行肌内注射（IM）的风险。
招募1至18岁接受胰岛素注射治疗的1型和2型糖尿病患儿，分为三个年龄组：1至6岁、7至12岁和13至18岁。使用便携式超声测量腹部、手臂、大腿和臀部四个注射部位的ST和SCT。
共有153名儿童参与该研究。腹部、手臂、大腿和臀部四个部位ST和SCT的平均（标准差）测量结果如下：1至6岁儿童分别为4.33毫米（±2.22）、5.55毫米（±2.26）、5.83毫米（±3.12）、6.48毫米（±3.47）；7至12岁儿童分别为7.11毫米（±3.68）、7.79毫米（±4.54）、7.17毫米（±3.62）、8.51毫米（±3.65）；13至18岁儿童分别为8.94毫米（±4.50）、8.42毫米（±5.00）、8.61毫米（±4.76）、9.76毫米（±4.38）。1至6岁的幼儿使用所有针长（即4、5、6、8和12.7毫米）进行肌内注射的风险最高，而7至12岁和13至18岁的大龄儿童使用较短针长（4、5和6毫米）的风险低于使用较长针长（8和12.7毫米）的风险。
应根据糖尿病患儿的年龄和体重指数，为接受胰岛素治疗的患儿提供合适针长的建议。
