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目的探讨一种新的、操作简单、不用外科缝合的新生儿脐静脉插管固定方法。方法选择2010年11月至2015年6月在本院新生儿监护室行脐静脉置管的患儿进行回顾性分析,其中应用荷包缝合固定导管的患儿为对照组,应用改良方法固定导管的患儿为改良组。改良组采用脐带结扎包里的气门芯结扎固定脐静脉导管,不用缝合,然后将外露导管环形盘绕在脐旁下腹部,灭菌透明敷贴固定;对照组采用经典的荷包缝合法,胶布搭桥固定。结果对照组15例,改良组17例,两组患儿导管留置时间[(8.6±2.0)天比(9.1±0.3)天]和置管后相关并发症发生率(感染6.7%比0,局部渗血13.3%比5.9%,腹胀26.7%比17.6%,拔管困难6.7%比0)差异均无统计学意义(P>0.05),两组均无导管脱出或插深以及拔管后出血病例。结论改良脐静脉插管固定方法可以避免外科缝合,缩短置管操作时间,操作简单,取材方便,并未增加相关并发症发生率。
Objective To explore a new method of umbilical vein cannulation and fixation in neonates without any surgical sutures. Methods From November 2010 to June 2015, we retrospectively analyzed the infants who underwent umbilical vein catheterization in our neonatal intensive care unit from November 2010 to June 2015. Among them, children with pocketed and sutured fixed catheters were used as the control group. Children as a modified group. In the improved group, the umbilical vein catheter was fixed by the valve core of the umbilical cord ligation bag without suturing, then the exposed catheter was wound around the lower abdomen of the umbilical cord for sterilization and transparence fixation. The control group was treated with classic purse suture and tape . Results The control group (n = 15) and modified group (n = 17), the catheterization time [(8.6 ± 2.0) days vs (9.1 ± 0.3) days) and the incidence of complications after catheterization Bleeding 13.3% vs 5.9%, abdominal distension 26.7% vs 17.6%, extubation difficulty 6.7% vs 0) showed no significant difference (P> 0.05). There was no catheter out or deep insertion and bleeding after extubation . Conclusion The improved method of umbilical vein cannulation can avoid surgical suture and shorten the operation time of catheter. The operation is simple and easy to draw, without increasing the incidence of related complications.