| Background:With the improvement of the social status of women, currently more common in older women, and because the concept of the environment, neonatal diseases, especially premature children, low birth weight newborns are more common at this time of normal feeding and breast-feeding may not be satisfied children with their needs. And the number of preterm children with serious diseases, such as neonatal severe pneumonia, respiratory tract infection, this time in need of emergency treatment, and newborn small blood vessels, repeated puncture or intravenous catheter may lead to vascular collapse, to the children the treatment caused some difficulties.With the improvement of medical standards and peripherally inserted central venous catheter puncture (Peripherally Inserted Central Cathete, PICC) to improve the birth and application of technology, PICC as long-term venous access is gradually being introduced into the treatment of neonatal, especially for preterm children, the treatment of low-birth-weight children and critically ill newborns is widely used, and achieved good results. Application and development of this technology from the fundamental solution to the past neonatal peripheral venous blood, catheter difficult to fix, indwelling intravenous needles shorter time series of problems for the clinical treatment of newborns and critically ill children exogenous energy supply provided an ideal intravenous access.Application of PICC technology, to some extent solves the problem of intravenous access, but how highly accurate, fast and efficient positioning is more difficult clinical problem. The study group on the need for hospital children PICC embodiment electrocardiogram, and with the current gold standard chest X-ray were compared to investigate the accuracy and economy of each positioning method.Objectives:To discuss the effectiveness of the application of electrocardiography monitor in locating the tip of peripherally inserted center catheter in neonates Discussion on the outer periphery of electrocardiogram law newborn inserted central venous catheters (Peripherally Inserted Central Catheter, PICC) puncture application results for clinicians to accurate, safe, timely, efficient and successful catheterization to provide evidence, in order to alleviate the suffering of the newborn to ensure that children can get treatment on time and quality to provide a basis on clinical.Methods:590 cases of newborns from January 2014 to June 2015 in our hospital were to be studied. According to randomized clinical trials of digital methods were divided into two groups, each 295 cases, of which the control group using X-ray positioning method PICC puncture, puncture the observation group method using electrocardiogram observed two groups of children with puncture success rate, the incidence of ectopic average puncture time (from the beginning to the needle positioning time required to complete), retention time, the required rate of complications and locate the puncture cost-benefit analysis, and the data were statistically analyzed.Main Results:(1) The observation group successful puncture 276 cases,19 cases of failure, puncture success rate was 93.56% in the control group successful puncture 273 cases,22 cases of failure, puncture success rate was 92.54%, compared to two puncture success rate, no statistical difference significance, p> 0.05;(2) Catheter chance observation group patients with X-ray target group ectopic (not into the superior vena cava) contrast observation group 295 cases,12 cases of ectopic occurrence of ectopic rate of 4.07% in the control group,295 cases, ectopic occurred in 26 cases, ectopic rate 8.81%. The chi-square test, the success rate of the observation group than the control group, the difference was significant, p<0.05;(3) The mean observation time of puncture (6.5±1.4) minutes, the control group, the average time of the puncture (13.5±4.6) minutes, two puncture time, the difference was statistically significant, p<0.05;(4) The observation group of children observed average retention time (11.8±3.9) days in the control group, the average retention time was (11.4±3.6) days, the two groups were compared to the average retention time, the difference was not statistically significant, p> 0.05;(5) The observation group 2 patients puncture site infection,2 cases of phlebitis, bleeding and edema in 3 cases, and 1 case detached,2 pipes get clogged, related complication rate was 3.39%, while the control group of 6 patients puncture site infection,7 cases of phlebitis, bleeding and edema in 4 cases,2 cases of detached,4 pipes get clogged, related complication rate was 7.80%, compared two groups of children complication rate, the difference was statistically significant, p<0.05;(6) Observer Group PICC puncture average consumption (20.6±3.4) million, significantly lower than the control group (123.6±12.4) million, compared to the two groups, the difference was significant, p<0.05.(7) Family members of patients in the observation group puncture overall satisfaction rate was 100%, significantly higher than the 89.83 percent, compared to the two groups, the difference was significant, p<0.05.Conclusions:1、ECG PICC catheter tip location targeting, not only can detect and adjust ectopic catheter, and guide the insertion depth of the PICC catheter, the success rate with the X-ray positioning similar.2、Both comparative overall success rate of catheter still in place relatively simple puncture time, complication rate, electrocardiogram law were higher X-ray method is fast, accurate, and no radiation damage, etc., suitable for PICC puncture catheter preferred catheter tip positioning method, especially newborns.3、Electrocardiogram law affordable, easier to promote, and is no radiation, no harm to the children a large extent, is worthy of further promotion. |
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