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[经大隐静脉外周置入中心静脉导管在早产儿中的最佳置管深度临床研究]

[A clinical study on the optimal placement depth for peripherally inserted central catheter through the great saphenous vein in preterm infants].

作者信息

Jiang Na, Qing Ling-Fang, Xiong Bo, Li Ying, He Li, Bo Tao

机构信息

Neonatal Intensive Care Unit, Department of Pediatrics, Third Xiangya Hospital of Central South University, Changsha 410011, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2024 Oct 15;26(10):1046-1052. doi: 10.7499/j.issn.1008-8830.2406005.

Abstract

OBJECTIVES

To investigate the correlation between optimal placement depth (OPD) and physical measurement parameters in preterm infants receiving placement of peripherally inserted central catheter (PICC) through the great saphenous vein (GSV), and to establish a predictive formula for OPD during the placement of PICC through the GSV.

METHODS

A retrospective analysis was performed for the preterm infants who received the placement of PICC through the GSV in the Neonatal Intensive Care Unit of the Third Xiangya Hospital of Central South University from December 2022 to February 2024. According to the site of puncture [GSV of the knee joint (KJ) or the ankle joint (AJ)], they were divided into a GSV-KJ placement group (=38) and a GSV-AJ placement group (=33). The infants were measured in terms of body weight (BW), body length, the length of the upper and lower parts of the body, head circumference, and abdominal circumference at the time of placement. The Pearson correlation analysis was used to investigate the correlation between the above variables and OPD. A predictive formula was established for OPD in the placement of PICC via the GSV in preterm infants, and the predicted residual between the predicted depth and the ideal OPD was compared between the conventional predictive formula and the new predictive formula.

RESULTS

The Pearson correlation analysis showed that PICC OPD was significantly positively correlated with BW, body length, the length of the upper and lower parts of the body, head circumference, and abdominal circumference in both the GSV-KJ placement group and GSV-AJ placement group (<0.05), with the highest degree of correlation between OPD and BW. The univariate linear regression analysis showed a linear relationship between PICC OPD and BW in both groups. The predictive formulas for OPD were as follows: GSV-KJ PICC OPD (cm) = 13.1 + 2.7 × BW (kg) and GSV-AJ PICC OPD (cm) = 13.4 + 6.0 × BW (kg), and the new predictive formulas had a significantly lower predicted residual than the conventional predictive formula (<0.05).

CONCLUSIONS

OPD for PICC through the GSV is positively correlated with BW, and the prediction results of the new predictive formula based on BW are closer to the ideal OPD.

摘要

目的

探讨经大隐静脉(GSV)行外周静脉穿刺中心静脉置管(PICC)的早产儿最佳置管深度(OPD)与体格测量参数之间的相关性,并建立经GSV行PICC置管时OPD的预测公式。

方法

对2022年12月至2024年2月在中南大学湘雅三医院新生儿重症监护病房经GSV行PICC置管的早产儿进行回顾性分析。根据穿刺部位[膝关节(KJ)或踝关节(AJ)的GSV],将其分为GSV-KJ置管组(=38)和GSV-AJ置管组(=33)。在置管时测量患儿的体重(BW)、身长、上下身长度、头围和腹围。采用Pearson相关性分析探讨上述变量与OPD之间的相关性。建立了早产儿经GSV行PICC置管时OPD的预测公式,并比较了传统预测公式和新预测公式在预测深度与理想OPD之间的预测残差。

结果

Pearson相关性分析显示,GSV-KJ置管组和GSV-AJ置管组中PICC OPD与BW、身长、上下身长度、头围和腹围均呈显著正相关(<0.05),OPD与BW的相关性最高。单因素线性回归分析显示两组中PICC OPD与BW均呈线性关系。OPD的预测公式如下:GSV-KJ PICC OPD(cm)=13.1+2.7×BW(kg),GSV-AJ PICC OPD(cm)=13.4+6.0×BW(kg),新预测公式的预测残差显著低于传统预测公式(<0.05)。

结论

经GSV行PICC的OPD与BW呈正相关,基于BW的新预测公式的预测结果更接近理想OPD。

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