新生坏死性小肠结肠炎经PICC行胃肠外营养的护理研究
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摘要
[目的]总结新生坏死性小肠结肠炎经外周置入中心静脉导管(PICC)行胃肠外营养的护理体会。[方法]对新生儿病房2014年11月—2015年5月需要肠外营养且放置PICC导管的68例坏死性小肠结肠炎患儿的临床资料进行回顾性分析。[结果]68例患儿均成功置入PICC导管,所有患儿总的留置时间为953导管日;导管留置时间为14.9d±2.0d。肠外营养使用的天数平均为7.98d,其中成功过渡到完全肠内营养且未发生不良事件者57例;发生导管不良事件11例,发生率为11.5/1 000个导管日,3例导管堵塞,1例体外断管,2例导管滑脱,5例发生静脉炎,因并发症拔管4例,采取对症治疗后继续PICC原位治疗7例。[结论]PICC可以为坏死性小肠结肠炎患儿提供安全有效的静脉通路,掌握PICC观察和维护的要点,可减少相关并发症的发生。
Objective:To summarize the nursing experience of parenteral nutrition with central venous catheter(PICC)in neonatal necrotizing.Methods:The clinical data of a total of 68 cases of necrotizing enterocolitis were retrospectively analyzed in the neonatal ward who may need parenteral nutrition and received the peripherally inserted central catheter(PICC)from May 2015 to November 2014.Results:All 68 patients received PICC successfully,the total indwelling time of all patients was 953days;the average indwelling time was 14.9d±2.0d.The average number of days for parenteral nutrition was 7.98 dincluding a successful transition to full enteral nutrition and no adverse events for 57cases;Catheter adverse events occurred for 11 cases,rate 11.5/1 000 catheter days,3cases of catheter obstruction,1case of in vitro diagnostic tube,2cases of catheter slippage,5cases of phlebitis,4cases of due to complications of extubation,7cases of take symptomatic treatment after to PICC in situ treatment.Conclusion:PICC can provide safe and effective venous access for the patients with necrotizing enteritis,and grasp the key points of observation and maintenance of PICC,can reduce the incidence of related complications.
Objective:To summarize the nursing experience of parenteral nutrition with central venous catheter(PICC)in neonatal necrotizing.Methods:The clinical data of a total of 68 cases of necrotizing enterocolitis were retrospectively analyzed in the neonatal ward who may need parenteral nutrition and received the peripherally inserted central catheter(PICC)from May 2015 to November 2014.Results:All 68 patients received PICC successfully,the total indwelling time of all patients was 953days;the average indwelling time was 14.9d±2.0d.The average number of days for parenteral nutrition was 7.98 dincluding a successful transition to full enteral nutrition and no adverse events for 57cases;Catheter adverse events occurred for 11 cases,rate 11.5/1 000 catheter days,3cases of catheter obstruction,1case of in vitro diagnostic tube,2cases of catheter slippage,5cases of phlebitis,4cases of due to complications of extubation,7cases of take symptomatic treatment after to PICC in situ treatment.Conclusion:PICC can provide safe and effective venous access for the patients with necrotizing enteritis,and grasp the key points of observation and maintenance of PICC,can reduce the incidence of related complications.
引文
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[2]姜毅.新生儿坏死性小肠结肠炎诊后进展[J].中国新生儿科杂志,2006,21(2):122-124.
[3]Lin-Hua Tan,Beth Hess.Survey of the use of peripherally inserted central venous catheters in neonates with critical congenital cardiac disease[J].Cardiol Young,2007(17):197.
[4]吴双伟.脉冲式封管法在静脉留置针输注静脉营养液中的应用[J].护理学杂志(综合版),2006,23(21):36-37.
[5]孟春英.外周中心静脉置管的护理[J].实用护理杂志,2003,19(2):46-47.
[6]Matsuzaki A,Suminoe A,Koga Y,et al.Long-Term Use of Peripherally Inserted Central Venous Catheters for Cancer Chemotherapy in Children[J].Support Care Cancer,2006,14(2):153-160.
[7]Foo R,Fujii A,Harris JA,et al.Complications in Tunneled CVL Versus PICC Lines in Very Low Birth Weight Infants[J].J Perinatol,2001,21(8):525-530.
[8]Anon.Intravenous Nursing Standards of Practice.Intravenous NursesSociety[J].J Intraven Nurs,1998,21(Suppl 1):34.