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。

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.