Percutaneous Central Venous Catheterization: Five Year Experiment in a Neonatal Intensive Care Unit

經皮式中央靜脈導管使用於新生兒加護中心

宋文舉(Wen-Jue Soong) ； 黃碧桃(Betau Hwang)

《Acta Paediatrica Sinica》 34卷5期 (1993/10) Pp. 356-366

摘要

在新生兒加護中心內，我們對臨床使用經皮式中央靜脈導管(PCVC)做一前瞻性的評估。在五年研究期間，共有610次PCVC成功的置放於496個新生兒，置放成功率為92%，總共使用天數為9,719天。這些嬰兒中82.7%只需使用一次PCVC中，337條(45.2%)是使用於體重小於或等於1,500公克的幼小早產兒。置入的年齡：所有導管的半數(50.7%)是於出生後24小時之內完成。
置入PCVC的部位：最常為手掌背部(48.8%)及手肘窩部(25.1%)。PCVC留置時間：平均每條17.6天（由1天至74天），體重小於或等於1,500公克組的留置期尚較長（19.5天）。
PCVC拔除的原因：在586條導管中79.2%是因不再需要，約各十分之一則是因機械問題(10.7%)及懷疑與感染有關(10.1%)；證明與導管有關的敗血症佔3.4%(20/586)，或2.1每千導管天。因此我們結論：在新生兒加護中心內為能維持長期的靜脈輸液治療，置放PCVC是一安全且有效的技術方法。

並列摘要

We evaluated the clinical application of percutaneous central venous catheter (PCVC) in our neonatal intensive care unit (NICU). During a five-year study, 610 PCVCs were placed in 496 infants for a total of 10,243 days. The success catheterization rate was 92%. Among them, 82.7% needed only one PCVC. The body weight of babies ranged from 460 g to 5,340g. Of 610 PCVCs, 337 (45.2%) were placed in infants weighing 1,500 g or less. About half (50.7%) of the PCVCs were placed within the first 24 hours of life. Common sites for insertion were the dorsal aspect of hands (48.8%) and the antecubital region (25.1%). Mean PCVC stay was 17.6 days (range, less than 1 to 74 days). The duration was longer (18.5 days) in infants weighing 1,500 g or less. Almost four fifth (79.2%) of 586 PCVCs were removed electively and one tenth was due to either mechanical problems (10.7%) or suspected catheter-related infection (10.1%). Of 586 PCVCs, catheter-related sepsis was confirmed in 3.4% (20/586), or 2.1 per 1,000 catheter-days. No immediate complication was attributed to the insertion procedure. We conclude that PCVC is a safe and effective technique for prolonged intravenous therapy in NICU.

並列關鍵字

central venous catheter ； percutaneous central venous catheter ； parenteral nutrition