【摘要】 目的 评估腔内心电定位技术在新生儿脐静脉置管中的应用效果，并探讨其对感染风险的影响。方法 本研究纳入2022年1月至2024年12月期间90例需进行脐静脉置管的新生儿，随机分为实验组(腔内心电定位技术，n=45)和对照组(传统置管方法，n=45)。主要观察指标为置管成功率、首次置管成功率、操作时间、及置管相关感染发生率(包括脐部感染和菌血症)。次要观察指标包括导管留置时间、早期并发症发生率以及新生儿的体重增长。结果 在应用效果方面，实验组的置管总成功率为91.11%(41/45),高于对照组的77.78%(35/45)(P=0.016)。首次置管成功率为73.33%(33/45)在实验组，而对照组为55.56%(25/45)(P=0.032)。操作时间方面，实验组均值为(8.12±1.47)min,短于对照组的(11.31±2.26)min(P<0.001)。实验组新生儿的导管留置时间为(8.42±1.26)d,相较于对照组的(10.12±2.31)d,差异有统计学意义(P=0.022)。在早期并发症方面，实验组的发生率为2.22%(1/45),低于对照组的6.66%(3/45)(P=0.027)。在感染风险方面，实验组置管相关感染发生率为6.67%(3/45),低于对照组的13.33%(6/45)(P=0.046)。多因素logistic回归分析表明，腔内心电定位技术为影响置管成功率和感染风险的独立因素：置管成功率的OR为2.41(95%CI:1.13-5.17,P=0.021);感染风险的OR为0.36(95%CI:0.12-0.98,P=0.045)。结论 腔内心电定位技术在新生儿脐静脉置管中的应用，提高了置管成功率，缩短了操作时间，并有效降低了置管相关感染的发生率。该技术不仅改善了置管的操作效果，还降低了新生儿的早期并发症发生率，具有广泛的临床应用潜力。更多还原

【Abstract】 Objective To evaluate the clinical efficacy of intracavitary electrocardiogram(IC-ECG)-guided positioning in neonatal umbilical vein catheterization(UVC),and to investigate its impact on infection risk. Methods A total of 90 neonates requiring UVC between January 2022 and December 2024 were prospectively enrolled and randomly assigned to the experimental group(IC-ECG-guided positioning, n=45) or the control group(conventional blind insertion, n=45). Primary outcomes included overall catheterization success rate, first-attempt success rate, procedure duration, and incidence of catheter-related infections(including omphalitis and bloodstream infection). Secondary outcomes included catheter dwell time, incidence of early complications, and neonatal weight gain. Results The experimental group demonstrated a higher overall success rate compared to the control group(91.11% [41/45] vs. 77.78% [35/45],P=0.016). The first-attempt success rate was also significantly higher in the IC-ECG group(73.33% [33/45] vs. 55.56% [25/45],P=0.032). The mean procedural time was significantly shorter in the experimental group(8.12±1.47 min vs. 11.31±2.26 min, P<0.001). Catheter dwell time was also reduced in the experimental group(8.42±1.26 days vs. 10.12±2.31 days, P=0.022). The incidence of early complications was lower in the IC-ECG group(2.22% [1/45] vs. 6.66% [3/45],P=0.027). Regarding infection risk, the catheter-related infection rate was significantly lower in the IC-ECG group(6.67% [3/45] vs. 13.33% [6/45],P=0.046). Multivariate logistic regression analysis identified IC-ECG-guided positioning as an independent predictor of both catheterization success and infection risk. The odds ratio(OR) for catheterization success was 2.41(95% CI:1.13-5.17,P=0.021),and the OR for infection risk was 0.36(95% CI:0.12-0.98,P=0.045). Conclusion The use of IC-ECG-guided positioning in neonatal UVC significantly improves catheterization success rates, shortens procedural time, and reduces the incidence of catheter-related infections. This technique also lowers the risk of early complications, indicating strong potential for widespread clinical application in neonatal intensive care settings.更多还原