| Background In recent years,with the implementation of the policy of fully liberating the two-child policy in China,the proportion of elderly pregnant women and puerpera has also increased,more and more twins and multiple pregnancies have appeared,and the Birth rate of high-risk neonates,especially Very Low Birth Weight Infants(VLBWI),has increased significantly.Objective To compare the clinical effects of bedside high-frequency ultrasound internal measurement and in vitro measurement alone in the tip positioning of the VLBWI upper limb Inserted Peripherally Central Catheter(PICC),and to explore the application value of bedside high-frequency ultrasound internal measurement method,and to provide theoretical basis for clinical promotion of this method.Methods A total of 120 VLBWI patients who received PICC catheterization in the neonatal department of the People’s Hospital of Three Gorges University and the First People’s Hospital of Yichang were included.61 infants who received PICC catheterization by bed high frequency ultrasound internal measurement from September 2019 to February 2021 were selected as the experimental group.From January 2018 to August 2019,59 infants who underwent in vitro measurement alone were retrospectively analyzed and set as the control group.General data were collected and the accuracy of catheterization,complication rate,success rate of catheterization,operation time of catheterization and indwetting time of catheterization in the two groups were observed.SPSS 20.0 software was used to analyze the corresponding parameters,and the final result P<0.05 was statistically significant.Results(1)The success rate of primary catheterization in the experimental group was significantly higher than that in the control group(P<0.05).The path heterotopic rate in the experimental group was significantly lower than that in the control group(P<0.05),The rate of loci ectopic was not statistically significant between the two groups(P>0.05).(2)The total complication rate of the experimental group was lower than that of the control group(P<0.05).(3)The success rate of the experimental group was significantly higher than that of the control group(P<0.05).(4)The operation time of catheterization in the experimental group was significantly shorter than that in the control group(P<0.05),and there was no statistical significance in the days of catheter indwelling between the two groups(P>0.05).(5)The sensitivity,specificity and Kappa index were 96.2%,62.5% and 0.62 respectively.(6)Risk factors analysis of ectopic: catheterization site(right and left)(OR=0.290,95%CI:0.084-0.996,P=0.049),catheterization method(OR=4.582,95%CI:1.209-17.366,P=0.025),Birth weight(OR=15.601,95%CI:3.996-60.902,P=0.001),simple in vitro measurement,weight<1000g Extremely Low Birth Weight Infant(ELBWI)and left upper limb catheterization were the main risk factors for ectopic catheterization.(7)The distance between catheter tip and right atrial entrance was measured by ultrasound(0.823±0.210)cm.Conclusion(1)Compared with the simple in vitro measurement method,bedside high-frequency ultrasound internal measurement method can significantly reduce the ectopic rate of PICC tip,mainly by reducing the ectopic rate of the path,but failed to significantly reduce the ectopic rate of the site.(2)The bedside high-frequency ultrasound internal measurement method can reduce the incidence of complications of catheterization,significantly improve the success rate of catheterization,and shorten the operation time of catheterization. |
PDF Full Text Request