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为评价经外周静脉置入中心静脉导管的可行性和安全性 ,选择32例极低体重儿进行外周静脉置入中心静脉导管术。方法 :通过贵要静脉、头静脉、肘正中静脉、大隐静脉置入中心静脉导管 ,靠X片确定和调整正确位置。结果显示成功放置中心静脉导管30例 (93.75 % ) ,导管平均放置时间 (23.6±13.6)天 ,置入导管长度 (12.6±4.7)cm。21例 (70.0% )过渡到胃肠道喂养后选择性拔管 ;3例怀疑导管相关感染提前拔管 ,其中2例证实感染与导管有关 ;6例因插管机械合并症拔管 ,包括2例导管阻塞 ,1例液体外渗 ,3例导管移位。无1例并发血栓栓塞、外周静脉炎、室上性心动过速。表明外周静脉置入中心静脉导管作为提供极低体重儿长期静脉营养的基本途径 ,可以在有条件的医疗单位推广使用。
To evaluate the feasibility and safety of peripheral venous catheterization in the central venous catheter, 32 cases of very low birth weight infants were selected for central venous catheterization. Methods: The main venous catheter, the first vein, the middle of the elbow vein, saphenous vein into the central venous catheter, X-ray to determine and adjust the correct position. The results showed that 30 cases (93.75%) of central venous catheters were successfully placed and the average catheterization time (23.6 ± 13.6) days was 12.6 ± 4.7 cm. Twenty-one patients (70.0%) transitioned to selective extubation after gastrointestinal feeding. Three patients suspected catheter-related infections were extubated in advance, of which two were confirmed as having a catheter-related infection. Six patients experienced catheter extubation due to mechanical complications including 2 Cases of catheter obstruction, 1 case of fluid extravasation, 3 cases of catheter shift. No cases of concurrent thromboembolism, peripheral phlebitis, supraventricular tachycardia. That the peripheral venous catheter into the central venous catheter to provide very low birth weight infants with long-term basic way of nutrition, can be used in conditional medical units.