Nursing care of a case of extremely low birth weight infant with pericardial effusion caused by central venous catheter insertion via umbilical vein
一例极低出生体重儿经脐静脉置入中心静脉导管并发心包积液的护理

摘要

目的 总结一例极低出生体重儿经脐静脉置入中心静脉导管导致心包积液救治成功的护理经验。方法 临床护理人员能够及时发现病情变化，为治疗争取时间，需要护理人员具备更高的观察能力和应急处理能力；掌握心包积液的临床表现，如呼吸急促、心率加快、心音低钝遥远、血压下降等，一旦发现异常，及时协助医生进行诊断和治疗；做好脐静脉置管护理，妥善固定导管，严格执行无菌操作，重点交接穿刺部位及导管位置，可降低导管相关并发症的发生风险；给予呼吸支持及营养支持护理，有利于病情的恢复；做好家长心理护理，提高了家长的配合度。结果 经过52天积极治疗与精心护理，患儿心包积液消失，生命体征平稳，患儿顺利康复出院。结论 护士具备脐静脉导管相关心包积液早期临床表现识别能力，及时发现病情变化，为治疗争取时间，降低患儿死亡率；置管前深度测量和定期监测脐静脉导管尖端位置，有效固定导管，避免心包积液的发生关键措施。

Abstract

Objective To summarize the nursing experience of successfully treating a case of extremely low birth weight infant with pericardial effusion caused by central venous catheter insertion via umbilical vein.
Methods Clinical nurses can promptly detect changes in the condition and gain time for treatment. Nurses need to have higher observation skills and emergency handling capabilities; Master the clinical manifestations of pericardial effusion, such as shortness of breath, increased heart rate, dull and distant heart sounds, and decreased blood pressure, and assist doctors in diagnosis and treatment as soon as abnormalities are found; Do a good job in umbilical vein catheter insertion care, properly fix the catheter, strictly follow aseptic operation, focus on the handover of the puncture site and catheter position, which can reduce the risk of catheter-related complications; Provide respiratory support and nutritional support care, which is conducive to the recovery of the condition; Do a good job in psychological care for parents, which improves the cooperation of parents.
Results After 52 days of active treatment and meticulous care, the pericardial effusion disappeared, the vital signs were stable, and the infant was successfully discharged from the hospital.
Conclusion   Nurses have the ability to identify the early clinical manifestations of pericardial effusion related to umbilical vein catheters, promptly detect changes in the condition, gain time for treatment, and reduce the mortality rate of the infant; Before catheter insertion, deeply measure and regularly monitor the tip position of the umbilical vein catheter, effectively fix the catheter, and avoid the occurrence of pericardial effusion as the key measure.