Abstract:

Objective The application effect of bedside ultrasound combined with joint movement protractor on the accurate monitoring and management of joint range of motion in extremely low birth weight infants was evaluated to reduce the incidence of secondary ectopic PICC in extremely low birth weight infants. Methods Convenience sampling was used to select 128 extremely low birth weight infants admitted to the neonatal intensive care unit of a tertiary hospital in Zhengzhou，Henan Province from February to September 2024. Among them，infants enrolled between June and September 2024 were assigned to an experimental group，while those enrolled between February and May 2024 were assigned to a control group，with 64 cases in each group. Whereas the experimental group，based on the control group，combined bedside ultrasound with a joint goniometer for precise monitoring and management of limb movement range in children with upper limb catheterization；the control group received routine prevention and management of PICC secondary displacement. After intervention，the incidence of PICC secondary displacement，the rate of PICC secondary displacement removal，the incidence of complications related to PICC secondary displacement，and the average length of stay of the infants were compared between the 2 groups. Results Ultimately，60 cases were included in each of the 2 groups. The incidence of secondary ectopic PICC in the post-intervention experimental group was 8.33%，lower of 23.33% in the control group；the extubation rate of secondary ectopic PICC was 3.33%，lower of 16.67% in the control group；the incidence of complications related to secondary ectopic PICC was 13.33%，lower of 51.67% in the control group；the average hospitalization day was 50（48，55）d，shorter of 61（55，65）d in the control group. The difference between the 2 groups was statistically significant（P<0.05）. Conclusion The combination of bedside ultrasound and joint movement protractor was used to accurately monitor and manage the range of motion of limbs in children with upper limb catheterization，which effectively guaranteed the safe position of the catheter tip and reduced the incidence of secondary ectopic complications related to PICC. It can be further promoted and applied in clinical practice.

Key words: Bedside Ultrasound, Joint Movement Protractor, Very Low Birth Weight Infants, Catheter Ectopic Secondary to PICC, Neonatal Nursing

摘要：

目的 评价床旁超声联合关节活动量角器在极低出生体重儿关节活动范围精准监测与管理中的应用效果，以减少其PICC继发性异位的发生。方法 采用便利抽样法，选取2024年2—9月于河南省郑州市某三级甲等医院新生儿重症监护病房的128例极低出生体重儿为研究对象，其中，2024年6—9月的患儿为试验组，2024年2—5月的患儿为对照组，每组各64例。试验组在对照组的基础上将床旁超声与关节活动量角器联合应用于经上肢置管患儿关节活动范围的精准监测与管理；对照组采用PICC继发性异位常规预防及处理方法。干预后比较两组PICC继发性异位发生率、PICC继发性异位拔管率、PICC继发性异位相关并发症的发生率及患儿平均住院日。结果 最终两组各纳入60例。干预后试验组PICC继发性异位发生率为8.33%，低于对照组的23.33%；PICC继发性异位拔管率为3.33%，低于对照组的16.67%；PICC继发性异位相关并发症的发生率为13.33%，低于对照组的51.37%；平均住院日为50（48，55）d，短于对照组的61（55，65） d，两组比较，差异均具有统计学意义（P<0.05）。结论 将床旁超声与关节活动量角器联合应用于经上肢置管患儿关节活动范围的精准监测与管理，有效保障了导管尖端位置安全，同时降低了PICC继发性异位相关并发症的发生率，促进了新生儿护理服务质量的提升。

关键词: 床旁超声, 关节活动量角器, 极低出生体重儿, PICC继发性异位, 新生儿护理