ISSN 2097-6046(网络)
ISSN 2096-7446(印刷)
CN 10-1655/R
主管:中国科学技术协会
主办:中华护理学会

中华急危重症护理杂志 ›› 2026, Vol. 7 ›› Issue (5): 561-563.doi: 10.3761/j.issn.2096-7446.2026.05.007

• 儿科重症护理风险识别与管理实践 • 上一篇    下一篇

对困难静脉超早产儿经胸腹壁置入中心静脉导管的护理

于相玲1(), 赵晓燕1,*(), 陈凡2, 林育敏2, 邓素芬1, 黄钰峰1   

  1. 1 厦门大学附属妇女儿童医院(厦门市妇幼保健院)新生儿科 厦门市 361003
    2 厦门大学附属妇女儿童医院(厦门市妇幼保健院)护理部 厦门市 361003
  • 收稿日期:2025-09-26 出版日期:2026-05-10 发布日期:2026-04-28
  • 通讯作者: *赵晓燕,E-mail:672598672@qq.com
  • 作者简介:于相玲:女,本科,副主任护师,E-mail:33784011@qq.com
    第一联系人:

    于相玲、陈凡:研究实施、循证分析、论文撰写;赵晓燕、邓素芬:研究指导;林育敏、黄钰峰:论文修改

  • 基金资助:
    福建省2023年省级临床重点专科建设项目(新生儿专业)(闽卫医政函〔2023〕1163号)

Nursing care of a premature infant with difficulty in catheterization and PICC catheter placement via thoracoepigastric vein

YU Xiangling1(), ZHAO Xiaoyan1,*(), CHEN Fan2, LIN Yumin2, DENG Sufen1, HUANG Yufeng1   

  1. 1 Department of NeonatologyWomen and Children’s Hospital Affiliated to Xiamen University(Xiamen Maternal and Child Health Hospital)Xiamen 361003, China
    2 Department of NursingWomen and Children’s Hospital Affiliated to Xiamen University(Xiamen Maternal and Child Health Hospital)Xiamen 361003, China
  • Received:2025-09-26 Online:2026-05-10 Published:2026-04-28
  • Contact: *ZHAO Xiaoyan,E-mail:672598672@qq.com
  • Supported by:
    Fujian Provincial Key clinical Specialty Construction Project in 2023(neonatal specialty)(Minwei Yizheng Letter〔2023〕1163)

摘要:

总结1例困难静脉超低出生体重儿成功经胸腹壁静脉置入中心静脉导管的护理体会。针对患儿早产、病程长、血管条件差、严重置管困难等问题,采取以下护理措施:置管前充分风险评估,选择胸腹壁静脉作为PICC穿刺部位;在置管中克服胸廓起伏的影响,选择适当的穿刺手法和穿刺时间以保证穿刺成功率,运用安抚、加温消毒液等方法防止血管收缩,辅助应用床旁超声定位;置管后积极观察有无PICC相关并发症发生。最终经胸腹壁静脉置入PICC导管成功,导管留置19 d内功能良好,未出现相关并发症。出院后门诊随访2年,患儿状况良好。

关键词: 婴儿, 超低出生体重, 导管插入术, 外周, 胸腹壁静脉, 危重症护理

Abstract:

To summarize the nursing experience of successfully placing a peripherally inserted central catheter (PICC) via the thoracoepigastric vein in an extremely low birth weight infant with difficult catheterization. The following nursing measures were adopted to address issues such as prematurity,prolonged illness,poor vascular conditions,and severe catheterization difficulties. We conducted a thorough risk assessment before catheterization and selected the thoracoepigastric vein as the PICC insertion site,overcame the impact of chest movements during catheterization by choosing appropriate puncture techniques and timing to ensure puncture success,used methods such as gentle soothing and warming the disinfectant to prevent vascular contraction,and assisted with bedside ultrasound guidance,actively monitored for PICC-related complications after catheterization. Ultimately,the PICC was successfully placed via the thoracoepigastric vein,ensuring timely completion of treatments. The catheter functioned well for 19 days without any complications. During a 2-year outpatient follow-up after discharge,the infant was in good condition.

Key words: Infant, Extremely Low Birth Weight, Catheterization, Peripheral, Thoracoepigastric Vein, Critical Care Nursing