Abstract:

Objective To investigate the application effect of tunneled femoral vein PICC insertion in infants and young children with difficult venous access，and to provide a reference for the selection of catheterization methods. Methods A total of 254 infants and young children with difficult venous access who were hospitalized in the Children’s Medical Center of a tertiary A general hospital in Changsha from April to October 2025 were selected by a convenience sampling method. They were divided into 2 groups by a simple random grouping method. The experimental group underwent tunneled femoral vein PICC insertion，while the control group underwent non-tunneled femoral vein PICC insertion. The incidence of catheter-related complications，success rate of one-time catheterization，catheterization duration，intraoperative blood loss，intraoperative pain score，catheter indwelling duration，and unplanned extubation rate were compared between the 2 groups. Results A total of 253 infants and young children completed the study，including 127 in the experimental group and 126 in the control group. The total incidence of catheter-related complications in the experimental group and the control group was 4.72% and 31.75%，respectively，with a statistically significant difference（P<0.001）. The incidence of catheter dislodgement，catheter-related infection，and catheter-related skin injury in the experimental group were lower than those in the control group，with statistically significant differences（P<0.05）. The unplanned extubation rate in the experimental group was 0，while that in the control group was 8.73%，with a statistically significant difference（P=0.001）. There were no statistically significant differences in other indicators between the 2 groups（P>0.05）. Conclusion Tunneled femoral vein PICC insertion can reduce the risk of catheter dislodgement，catheter-related infection，and catheter-related skin injury in infants and young children with difficult venous access，and decrease the unplanned extubation rate，without affecting the success rate of one-time catheterization，intraoperative blood loss，or pain degree.

Key words: Subcutaneous Tunneling Technique, Femoral Venous, Peripherally Inserted Central Catheter, Difficult Venous Access, Pediatric Nursing

摘要：

目的 探讨隧道式经股静脉PICC置入术在困难静脉通路婴幼儿中的应用效果，为置管方式的选择提供参考。方法 采用便利抽样法，选取2025年4—10月在长沙市某三级甲等综合医院儿童医学中心住院的254例困难静脉通路婴幼儿作为研究对象。采用简单随机分组法将其分为两组，试验组采用隧道式经股静脉PICC置入术置管，对照组采用非隧道式经股静脉PICC置入术置管。比较两组导管相关并发症发生率、一次性置管成功率、置管时长、术中出血量、术中疼痛评分、导管留置时长、非计划性拔管率。结果 253例婴幼儿完成研究，其中试验组127例、对照组126例。试验组和对照组的导管相关并发症总发生率分别为4.72%、31.75%，差异具有统计学意义（P<0.001），其中试验组导管脱出、导管相关性感染、导管相关性皮肤损伤发生率均低于对照组，差异具有统计学意义（P<0.05）。试验组非计划性拔管率为0，对照组为8.73%，差异具有统计学意义（P=0.001）。两组其他指标比较，差异均无统计学意义（P>0.05）。结论 采用隧道式经股静脉PICC置入术可减少困难静脉通路婴幼儿导管脱出、导管相关性感染及导管相关性皮肤损伤的发生风险，降低非计划性拔管率，且未影响一次性置管成功率、术中出血量及疼痛程度等。

关键词: 皮下隧道技术, 股静脉, 经外周静脉置入中心静脉导管, 困难静脉通路, 儿科护理学