新生儿脐静脉置管并发症的危险因素分析及护理干预措施王清娴;张咏媚;游玉青
【摘要】目的:探讨新生儿脐静脉置管并发症常见的危险因素并根据其主要的危险因素制定护理干预措施.方法:采用回顾性分析的研究方法,收集2016年4月～2017年4月我院新生儿科收治的128例行UVC新生儿的临床资料.运用单因素分析和多因素非条件logistic回归分析影响新生儿UVC并发症的危险因素.结果:128例UVC新生儿中,总共有37例患者发生并发症,发生率28.91％.单因素分析结果显示:不同胎龄、不同出生体重、不同分娩方式、不同营养支持方式、有无先天性疾病、置管位置和深度是否标准、置管时间长短等因素之间,并发症的发生率有统计学意义(P<0.05).logistic回归分析结果显示:不同胎龄、不同出生体重、不同营养支持方式、置管位置和深度是否标准、置管时间长短是发生UVC并发症的独立因素,其中,早产、低出生体重、肠外营养、置管位置和深度不标准、置管时间过长是发生UVC并发症的独立危险因素;足月产、正常出生体重、肠内营养、置管位置和深度标准、置管时间适宜是发生UVC并发症的独立保护因素.结论:新生儿UVC并发症危险因素较多,发生率高,护理人员应加强UVC的护理,尽量减少UVC并发症的发生.%Objective: To explore common risk factors for complications of newborn umbilical vein cathetering and apply nursing intervention measures ac-cording to its vital risk factors. Methods: Apply retrospective analysis as research method, and collect the clinical data of 128 cases of UVC newborn cured in pediatric department of our hospital from April 2016 to April 2017. Analyze risk factors for complications of UVC newborn by application of single - factor analysis and multi - factor unconditional logistic regression analysis. Results: Among 128 cases of UVC newborn,
total 37 cases had complications, ac-counting for 28. 91. The result of single - factor indicated: for factors such as different gestational age, different birth weight, different delivery mode, dif-ferent nutrition supporting method and whether existing congenital diseases, whether cathetering location and depth in accordance with standards, cathether-ing duration, and the occurrence rate of complications was statistically significant(P < 0. 05). The result of logistic regression analysis indicated: different gestational age, different birth weight, and different nutrition supporting method, whether cathetering location and depth in accordance with standards, cathethering duration were independent factor for UVC complications, in which, premature birth, low birth weight, parenteral nutrition, non - standard cathetering location and depth, long cathetering duration were independent risk factor for UVC complications. Full - term birth, normal birth weight, enter-al nutrition, standard cathetering location and depth, proper cathethering duration were independent protection factor for UVC complications. Conclusion:There are many risk factors for newborn UVC complications and the occurrence rate is high, so nurses shall strengthen UVC nursing and try to reduce the oc-currence of UVC complications.
【期刊名称】《护理实践与研究》
【年(卷),期】2018(015)003
【总页数】3页(P9-11)
【关键词】新生儿;脐静脉置管;并发症;危险因素;护理干预
【作者】王清娴;张咏媚;游玉青
【作者单位】528200 佛山市佛山市南海区桂城医院;528200 佛山市佛山市南海区桂城医院;528200 佛山市佛山市南海区桂城医院
【正文语种】中文
新生儿脐静脉置管(umbilical venous catheter，UVC)是新生儿重症监护病房一项重要的救治技术。当前，新生儿外周中心静脉置管(peripherally inserted central catheter,PICC)应用较为广泛，置管成功率较高。但是，对于早产儿、低出生体重新生儿，PICC置管的难度较大，难以长时间保留。输注高渗液体及刺激性较大的药物时，容易外渗造成皮肤肿胀、疼痛，甚至皮下组织坏死。反复穿刺不仅加重患儿痛苦，而且增加相关并发症的发生率[1]。相比于PICC，UVC简便易行，可以长时间留置，能建立更加有效而稳固的静脉通路，从而实施静脉补液营养支持、采血、输血以及换血治疗等[2]。但同PICC一样，UVC也不可避免的存在相关并发症，如导管相关性感染、腹胀、脐出血、空气栓塞、导管移位、坏死性小肠结肠炎等[3-4]。本研究采用回顾性分析的方法，对我院实施UVC新生儿的临床资料进行总结分析，探讨新生儿UVC并发症常见的危险因素并根据其主要的危险因素制定相关护理干预措施，现报道如下。
1 对象与方法
1.1 研究对象收集2016年4月～2017年4月我院新生儿科收治的286例危重新生儿的临床资料，其中135例新生儿行UVC，最终因病情过重死亡7例，最终纳入研究行UVC新生儿128例。
