摘要
目的探讨不同浓度地塞米松溶液预处理导管预防早产儿PICC所致静脉炎的效果及其安全性,并研究其合理剂量。方法将180例需行PICC置管术的低出生体重儿随机分为三组,每组各60例,均依据标准操作规范置入PICC,置管前分别采用0.08mg/mL(观察1组)、0.04mg/mL(观察2组)地塞米松稀释液30mL及生理盐水30mL(对照组)浸泡PICC,浸泡时间均为5min。比较三组患儿置管术后静脉炎的发生率、出现时间、严重程度及其他并发症等。结果三组静脉炎发生率、静脉炎程度及发生时间比较,差异有统计学意义(P<0.05,P<0.01);其中观察1组静脉炎发生率及发生时间显著低于和迟于对照组(P<0.0125,P<0.05);观察2组与对照组相比,虽静脉炎发生时间推迟(P<0.05),但发生率差异无统计学意义(P>0.0125);使用地塞米松预处理后患儿静脉炎严重程度显著降低(P<0.01)。三组患儿其他置管相关并发症发生率比较,差异无统计学意义(P>0.05)。结论在早产儿PICC置管前,使用0.08mg/mL地塞米松溶液浸泡预处理导管,能减轻PICC所致静脉炎发生率及其严重程度,且能延缓静脉炎的发生。
Objective To investigate the value and safety of PICC line immersed in different concentration dexamethasone （DEX） solutions at pre-puncture phase for prevention of PICC related phlebitis in premature infants,and to explore a reasonable dose of DEX solution.Methods Totally,180 low-birth weight premature infants who needed PICC placement were randomly divided into three groups,with 60 cases in each group.All groups were treated with standard procedures.Before puncture,the PICC lines were immersed in 30 mL of 0.08 mg/mL （Group 1）,or 0.04 mg/mL（Group 2） DEX solution,or normal saline （control group） for 5 min.The incidence rate of PICC related phlebitis,the time to develop phlebitis,the severity of phlebitis and other complications were compared among the three groups.Results The incidence rate of PICC related phlebitis,the severity of and the time to develop phlebitis among the three groups had significant differences（P＜0.05,P＜0.01）,with the rate of phlebitis and the time to develop phlebitis in Group 1 less and later than in the control group（P＜0.0125,P＜0.05） ; the time to develop phlebitis in Group 2 was later than the control group（P＜0.05）,whereas the incidence rate of phlebitis had no significant difference（P＞0.0125）; the severity of phlebitis was milder with the usage of DEX solution（P＜0.01）.The incidence rate of other complications had no significant difference（P＞0.05）.Conclusion The use of 0.08 mg/mL DEX solution to immerse PICC line before placement could reduce the frequency and severity of PICC related phlebitis; it also delays the time to develop PICC related phlebitis in premature infants.
基金
福建省漳州市自然科学基金科技项目(ZZ2013J32)
关键词
早产儿
经外周中心静脉置管术
导管预处理
地塞米松
生理盐水
静脉炎
安全性
premature infants
peripherally inserted central catheter
catheter immersion
dexamethasone
normal saline
phlebitis
safety
