The Analysis Of Influence Factors Of PICC Heterotopia And The Research Of The Optimal Inserted Length In Premature Infants

Objects:The study was aimed to investigate the status of PICC heterotopia in a three level hospital of Changchun,by statistically analyzing the clinical data of premature infants with PICC;To explore the influencing factors of PICC heterotopia in premature infants,It will provide scientific evidence for clinical PICC special nurses;To analysis the position of PICC catheter tip and the correlation between the optimal inserted length and weight on the basis of radio-graphic tips landmark of PICC,in order to make out a more accurate method of the length of PICC placement in NICU.To improve PICC once in place,reduce the incidence of PICC related complications and improve the quality of nursing care for premature infants with PICC. Methods:The research consisted of two parts,adopting retrospective study method.Part one:A retrospective analysis method was used to extract the clinical date of 1129 premature infants with PICC from a cluster information management platform of a three hospital in Changchun between January 2010 and December 2014.To analysis the influencing factors of PICC heterotopia.Epi Data3.02 software was adopted to establish a database where the data were inputted. The clinical data were analyzed by SPSS17.0.The data were analyzed by descriptive analysis(mean,standard deviation,frequency and composition ratio), uni-variate analysis and unconditioned logistic regression analysis of multivariate analysis.Part two:A retrospective analysis method was used to extract the clinical date of 377 premature infants with PICC from a cluster information management platform of a three hospital in Changchun between January 2014 and December 2014.The body weight(X) of 292 premature infants with PICC were surveyed.According to the different puncture position,292 cases were divided into ten groups: basilic vein,cephalic vein,median cabital vein,popliteal vein,the great saphenous vein on the right and left.On the basis of radio-graphic tips landmark of PICC,the position of the catheter tip is analyzed and the optimal inserted length of PICC on the day of DR. Epi Data3.02 software was to establish a database where the data were inputted. The clinical dates were analyzed by SPSS17.0. The data were analyzed by descriptive analysis(mean,standard deviation,frequency and composition ratio),Pearson correlation analysis and linear regression analysis. Result:1.The minimum gestational age of premature infants is 25 weeks,the maximum is 36+6weeks,with an average of(31±2.28)weeks;the minimum weight of premature infants is 350 g,the maximum is 3960 g,with an average of(1479±379)g.The incidence of PICC heterotopia is42.1%、42.7%、40.5%、38.6%and40.1% in Changchun from 2010 to 2014.2.The different gestational age,body weight,the mechanical ventilation,catheter site,catheter vein and operator of PICC and so on affected the incidence of PICC heterotopia,and the difference was statistically significant(P<0.05).3.Multivariate non-conditional Logistic analysis revealed that the body weight,catheter vein,catheter site,the operator of PICC and the mechanical ventilation were entered into the regression model.4.Among 377 premature infant,deep position:67(17.8%);shallow position:27(7.2%);optimal position:206(54.6%);malposition:77(20.4%).5.The tips position of PICC among different vein groups is different,and the difference was statistically significant(P<0.05).6.There is a positive correlation between the optimal length of PICC catheter and the body weight of premature infants. Conclusions:1.The incidence rate of PICC malposition in premature infants was 40.1% from 2010 to 2014.2.The influencing factors of PICC in premature infants include gestational age,body weight,the catheter day,the mechanical ventilation,the catheter placement,the catheter vein,the operator of PICC.Among them,the body weight,the catheter vein,the mechanical ventilation and the operator of PICC are the main factor.3.The rate of the tip in place of basilic vein is highest, the popliteal vein ranked second.Therefore,it is reasonable to choose the vein in the clinical setting for the premature infants according to their own situation.4.There is a positive correlation between the optimal length of PICC catheter and the body weight of premature infants.Because of the limitations of the sample size,the regression equation is needed to further clinical examination and correction.