临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (1): 19-21.doi: 10.3969/j.issn.1000-3606.2019.01.005

• 新生儿疾病专栏 • 上一篇    下一篇

经外周中心静脉置管相关性新生儿胸腔积液2 例临床分析

张成强,陆澄秋,钱蓓倩,等   

  1. 复旦大学附属妇产科医院(上海 200011)
  • 出版日期:2019-01-15 发布日期:2019-02-01
  • 通讯作者: 汪吉梅 电子信箱:wjm8219@163.com

The clinical analysis of pleural effusion associated with peripherally inserted central catheters in two neonates

ZHANG Chengqiang, LU Chengqiu, QIAN Beiqina, et al   

  1. Department of Neonatology, Obstetrics and Gynecology Hospital Affiliated to Fudan University, Shanghai 200011, China)
  • Online:2019-01-15 Published:2019-02-01

摘要:  目的 探讨新生儿期经外周中心静脉置管(PICC)相关性胸腔积液的临床特点。方法 回顾分析2例经外周 中心静脉置管致胸腔积液新生儿的临床资料。结果 2例患儿均为女性早产儿;例1为26+5周分娩,出生体质量800 g,于 放置PICC后8小时出现呼吸困难加重,床旁胸片提示右侧大量胸腔积液,予以拔除PICC、行右侧胸腔积液穿刺抽液并胸 腔闭式引流6天后胸腔积液治愈;例2为29+3周分娩,出生体质量1240 g,于放置PICC后3天出现呼吸困难加重,床旁胸 部X线片提示为双侧胸腔积液,予以拔除PICC、行双侧胸腔积液穿刺抽液后治愈。根据胸水常规和生化指标,结合病史, 例1符合乳糜胸诊断,例2考虑为液体外渗。结论 新生儿PICC相关性胸腔积液较少见,但病因不一且进展迅速;临床需 警惕并积极处理。

关键词:  中心静脉置管; 胸腔积液; 乳糜胸; 新生儿

Abstract:  Objective To explore the clinical characteristics of pleural effusion associated with peripherally inserted central catheters (PICCs) in neonates. Method The clinical data of pleural effusion caused by PICCs in two neonates were retrospectively analyzed. Results Both 2 cases were preterm female infants. Case 1 was delivered at 26+5 weeks, with a birth weight of 800 g. Dyspnea aggravated 8 hours after the PICC placement. Bedside chest radiograph indicated a large amount of pleural effusion on the right side. PICC was removed, puncture and drainage were performed, and pleural effusion was cured after 6 days of closed thoracic drainage. Case 2 was delivered at 29+3 weeks with a birth weight of 1240 g. Three days after placement of PICC, dyspnea became worse. Bedside chest radiograph showed bilateral pleural effusion, which was cured after PICC removal, puncture and drainage. According to the routine and biochemical indexes of pleural effusion, combined with the medical history, case 1 was consistent with the diagnosis of chylothorax and case 2 was considered as fluid exudation. Conclusion Neonatal PICC - associated pleural effusion is rare, but the etiology is varied and progress is rapid. Vigilance and active treatment is needed in clinic.

Key words:  peripherally inserted central catheter; pleural effusion; chylothorax; neonate