Nursing of an extremely preterm infant with difficulty in dilation and extubation of PICC catheter indwelling through femoral vein
高榕瑛 1程莉萍 1李秋平 1陈彩玲 1周京京2
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作者信息
1. 解放军总医院第七医学中心,北京 100700
2. 海南现代妇女儿童医院,海南海口 570100
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摘要
总结1例超早产儿(extremely preterm infant,EPI)经股静脉留置PICC导管扩张拔管困难的护理措施.患儿因"窒息复苏后机械通气4 h"于2023年3月17日入住解放军总医院第七医学中心新生儿重症监护室(neonatal intensive care unit,NICU),并经股静脉穿刺中心静脉置管(peripherally inserted central catheter,PICC),PICC留置第40天出现管路堵塞,尝试拔管失败,行胸腹X片显示体内导管约2.5 cm长未见显影,但内外长度与导管尖端位置均未发生改变,经气管插管、肌松、施压回抽后成功拔除导管.患儿住院100 d后体重达2.87 kg,治愈出院.EPI发生PICC拔管困难时切勿暴力拔管,需认真查找并分析原因,采用适合的措施,安全拔除导管.
Abstract
Nursing care for a case of extremely preterm infant(EPI)with difficulty in dilation and extubation of peripherally inserted central catheter(PICC)catheter through femoral vein catheterization was summarized.The pa-tient was admitted to the neonatal intensive care unit(NICU)of the Seventh Medical Center of the People's Libera-tion Army General Hospital on March 17,2023,due to"mechanical ventilation for 4 h after suffocation resuscita-tion",and PICC was inserted through the femoral vein puncture.On the 40th day of PICC placement,the catheter was blocked and the attempt to remove it failed.Chest and abdominal X-rays showed that the catheter was approxi-mately 2.5 cm long without visualization,but the internal and external lengths and the position of the catheter tip did not change,and the catheter was successfully removed after intubation,muscle relaxation,and pressure retraction.The patient weighed 2.87 kg after being hospitalized for 100 d and was discharged after recovery.When PICC is dif-ficult to extubate in EPI,do not forcefully remove the catheter.It is necessary to carefully investigate and analyze the cause,and take appropriate measures to safely remove the catheter.
关键词
外周静脉置入中心静脉导管/拔管困难/导管扩张/股静脉/超早产儿
Key words
peripherally inserted central catheter/difficulty in extubation/catheter dilation/femoral vein/extremely preterm infant
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