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Article(id=1322168410457359068, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322168387082502716, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.06.017, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1746547200000, receivedDateStr=2025-05-07, revisedDate=1770566400000, revisedDateStr=2026-02-09, acceptedDate=null, acceptedDateStr=null, onlineDate=1793159113753, onlineDateStr=2026-10-28, pubDate=1774368000000, pubDateStr=2026-03-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793159113753, onlineIssueDateStr=2026-10-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793159113753, creator=13701087609, updateTime=1793159113753, updator=13701087609, issue=Issue{id=1322168387082502716, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='6', pageStart='881', pageEnd='1056', issueExtLink='null', onlineDate='null', pubDate='1774368000000', pubDateStr='2026-03-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793159108180, creator='13701087609', updateTime=1793159108180, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1004, endPage=1010, ext={EN=ArticleExt(id=1322168410688045789, articleId=1322168410457359068, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Clinical study on predicting standardised PICC line placement lengths for different veins in low birth weight infants based on body parameters, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the correlation between peripherally inserted central catheter(PICC) standardized catheterization length and body parameters in low birth weight infants(LBWI),and to construct a predictive formula for PICC standardized catheter placement length.

Methods

A total of 175 LBWIs who received PICC in the right upper limb or right lower limb in the neonatal intensive care unit of Shanxi Bethune Hospital were selected as research subjects from January 2023 to December 2024.General demographic data(gender,postnatal age at catheterization) and catheterization data[catheterization vein,arm circumference(for upper limb),calf circumference(for lower limb),body weight at catheterization,standardized catheter placement length] were collected.Pearson correlation analysis was used to explore the correlation between variables and standardized catheter placement length for each vein.Based on simple linear regression analysis results,predictive formulas for PICC standardized catheter placement length in different veins for LBWIs were constructed.Bland-Altman plots were used to analyze the agreement between predicted and actual insertion lengths for each vein.

Results

Standardized catheter placement lengths for the right basilic vein,right median cubital vein,right cephalic vein,and right great saphenous vein were all positively correlated with arm circumference,calf circumference and body weight at catheterization(all P<0.05).Standardized catheter placement lengths for the right basilic vein and right great saphenous vein were also positively correlated with postnatal age at catheterization(both P<0.05).Among all parameters,body weight at catheterization showed the highest correlation with standardized catheter placement length for all four veins.Based on simple linear regression analysis,four prediction equations were constructed to predict the standardized catheterization length. Standardized catheter placement length for right basilic vein=6.941+2.562×body weight at catheterization(kg).Standardized catheter placement length for right median cubital vein=8.110+2.153×body weight at catheterization(kg).Standardized catheter placement length for right cephalic vein=7.583+2.539×body weight at catheterization(kg).Standardized catheter placement length for right great saphenous vein=16.574+3.953×body weight at catheterization(kg).Bland-Altman plots showed that the mean differences between predicted and actual insertion lengths were small for all four veins,with almost all data points falling within the 95% confidence interval.

Conclusions

PICC standardized catheter placement length in LBWIs is positively correlated with body weight at catheterization.The prediction formulas based on body weight at catheterization demonstrate high accuracy.

, authors=Li WANG, Meibian GU, Yiwei LI, Jiaying GUO, Yanrong LU, authorsList=Li WANG, Meibian GU, Yiwei LI, Jiaying GUO, Yanrong LU, authorCompany=null, correspAuthors=Meibian GU, authorNote=null, correspAuthorsNote=
GU Meibian, E-mail:
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目的

分析低出生体重儿（LBWI）的经外周静脉置入中心静脉导管（PICC）标准化置管长度与身体参数的相关性，构建PICC标准化置管长度预测公式。

方法

选取2023年1月—2024年12月在山西白求恩医院新生儿重症监护室（ICU）接受右上肢及右下肢PICC的175例LBWI为研究对象，收集病人一般人口学资料（性别、置管日龄等）及置管资料［置管静脉、臂围（上肢置管时）、小腿围（下肢置管时）、置管时体重、标准化置管长度等］，采用Pearson相关分析探讨变量与各置管静脉标准化置管长度的相关性，基于简单线性回归分析结果构建LBWI不同静脉PICC标准化置管长度的预测公式，采用Bland-Altman图分析各静脉置管长度预测值与实际值间的一致性。

结果

右贵要静脉、右肘正中静脉、右头静脉、右大隐静脉标准化置管长度均与臂围、小腿围、置管时体重呈正相关（均P<0.05）；右贵要静脉、右大隐静脉标准化置管长度均与置管日龄呈正相关（均P<0.05），4种静脉的标准化置管长度与置管时体重相关性均最高。基于简单线性回归分析构建4个预测方程预测标准化置管长度，即右贵要静脉标准化置管长度=6.941+2.562×置管时体重（kg）；右肘正中静脉标准化置管长度=8.110+2.153×置管时体重（kg）；右头静脉标准化置管长度=7.583+2.539×置管时体重（kg）；右大隐静脉标准化置管长度=16.574+3.953×置管时体重（kg）。Bland-Altman图显示，4种静脉置管长度预测值与实际值间差值的均值较小，所有测量数据基本介于95%置信区间。

结论

低出生体重儿PICC标准化置管长度与置管时体重呈正相关，依据置管时体重构建的预测公式预测准确度较高。

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王丽，副主任护师，硕士研究生

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谷美便，E-mail：
GU Meibian, E-mail:
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peripherally inserted central catheters in neonates, refAbstract=null), Reference(id=1322530257660399668, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168410457359068, doi=null, pmid=null, pmcid=null, year=2001, volume=19, issue=3, pageStart=235, pageEnd=236, url=null, language=null, rfNumber=19, rfOrder=18, authorNames=贺生, 刘荣志, 范真, journalName=中国临床解剖学杂志, refType=null, unstructuredReference=贺生,刘荣志,范真,等.新生儿颈内静脉穿刺置管术的应用解剖[J].中国临床解剖学杂志,2001,19(3):235-236., articleTitle=新生儿颈内静脉穿刺置管术的应用解剖, refAbstract=null), Reference(id=1322530257744285749, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168410457359068, doi=null, pmid=null, pmcid=null, year=2020, volume=1, issue=5, pageStart=463, pageEnd=467, url=null, language=null, rfNumber=20, rfOrder=19, authorNames=范歆颀, journalName=中华急危重症护理杂志, refType=null, unstructuredReference=范歆颀.新生儿PICC导管继发性异位的临床特点及研究进展[J].中华急危重症护理杂志,2020,1(5):463-467., articleTitle=新生儿PICC导管继发性异位的临床特点及研究进展, 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journalName=Advances in Neonatal Care, refType=null, unstructuredReference=ARMBRUSTER D,SLAUGHTER J,STENGER M,et al.Neonatal anthropometric measures and peripherally inserted central catheter depth[J].Advances in Neonatal Care,2021,21(4):314-321., articleTitle=Neonatal anthropometric measures and peripherally inserted central catheter depth, refAbstract=null), Reference(id=1322530258000138296, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168410457359068, doi=null, pmid=null, pmcid=null, year=2019, volume=60, issue=3, pageStart=305, pageEnd=310, url=null, language=null, rfNumber=23, rfOrder=22, authorNames=CHEN I L, OU-YANG M C, CHEN F S, journalName=Pediatrics and Neonatology, refType=null, unstructuredReference=CHEN I L,OU-YANG M C,CHEN F S,et al.The equations of the inserted length of percutaneous central venous catheters on neonates in NICU[J].Pediatrics and Neonatology,2019,60(3):305-310., articleTitle=The equations of the inserted length of 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articleId=1322168410457359068, language=EN, label=Figure 4, caption=Comparison of predicted and actual catheter length for right great saphenous vein, figureFileSmall=RkfRSWVqdFXwf5Zhfk3BpA==, figureFileBig=0s/bFbHqbFlfP93n5LzgNw==, tableContent=null), ArticleFig(id=1322530255718436891, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168410457359068, language=CN, label=图4, caption=右大隐静脉置管长度预测值与实际值比较, figureFileSmall=RkfRSWVqdFXwf5Zhfk3BpA==, figureFileBig=0s/bFbHqbFlfP93n5LzgNw==, tableContent=null), ArticleFig(id=1322530255789740060, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168410457359068, language=EN, label=Table 1, caption=

General data of LBWIs(n=175)

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类例数构成比（%）
性别男9051.4
女8548.6
置管日龄<8 d11766.9
8~14 d5229.7
>14 d63.4
置管时体重<1.0 kg2715.4
1.0~<1.5 kg12169.1
1.5~<2.0 kg2614.9
2.0~2.5 kg10.6
置管静脉右贵要静脉7341.7
右肘正中静脉3520.0
右大隐静脉4123.4
右头静脉1810.3
左贵要静脉84.6
上肢置管LBWI臂围（n=134）5.0~6.0 cm4936.6
>6.0~7.0 cm7354.5
>7.0~8.0 cm118.2
>8.0~9.0 cm10.7
上肢置管LBWI上肢标准化置管长度（n=134）8.5~9.0 cm107.5
>9.0~10.0 cm3526.1
>10.0~11.0 cm6850.7
>11.0~12.0 cm2115.7
下肢置管LBWI小腿围（n=41）5.0~6.0 cm1331.7
>6.0~7.0 cm1536.6
>7.0~8.0 cm1331.7
下肢置管LBWI下肢标准化置管长度（n=41）19.5~20.0 cm717.1
>20.0~21.0 cm1229.3
>21.0~22.0 cm1434.1
>22.0~23.0 cm512.2
>23.0~24.0 cm37.3
), ArticleFig(id=1322530255865237533, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168410457359068, language=CN, label=表1, caption=

LBWI一般资料（n=175）

, figureFileSmall=null, figureFileBig=null, tableContent=
项目分类例数构成比（%）
性别男9051.4
女8548.6
置管日龄<8 d11766.9
8~14 d5229.7
>14 d63.4
置管时体重<1.0 kg2715.4
1.0~<1.5 kg12169.1
1.5~<2.0 kg2614.9
2.0~2.5 kg10.6
置管静脉右贵要静脉7341.7
右肘正中静脉3520.0
右大隐静脉4123.4
右头静脉1810.3
左贵要静脉84.6
上肢置管LBWI臂围（n=134）5.0~6.0 cm4936.6
>6.0~7.0 cm7354.5
>7.0~8.0 cm118.2
>8.0~9.0 cm10.7
上肢置管LBWI上肢标准化置管长度（n=134）8.5~9.0 cm107.5
>9.0~10.0 cm3526.1
>10.0~11.0 cm6850.7
>11.0~12.0 cm2115.7
下肢置管LBWI小腿围（n=41）5.0~6.0 cm1331.7
>6.0~7.0 cm1536.6
>7.0~8.0 cm1331.7
下肢置管LBWI下肢标准化置管长度（n=41）19.5~20.0 cm717.1
>20.0~21.0 cm1229.3
>21.0~22.0 cm1434.1
>22.0~23.0 cm512.2
>23.0~24.0 cm37.3
), ArticleFig(id=1322530255940735006, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168410457359068, language=EN, label=Table 2, caption=

Correlation between standardized catheter placement length and different clinical parameters(r value)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量右贵要静脉标准化置管长度右肘正中静脉标准化置管长度右头静脉标准化置管长度右大隐静脉标准化置管长度
性别-0.1000.0040.216-0.242
置管日龄0.385①0.0140.4070.520①
臂围0.782①0.385①0.824①
小腿围0.703①
置管时体重0.888①0.639①0.890①0.914①
), ArticleFig(id=1322530256007843871, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168410457359068, language=CN, label=表2, caption=

标准化置管长度与不同临床参数的相关性（r值）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量右贵要静脉标准化置管长度右肘正中静脉标准化置管长度右头静脉标准化置管长度右大隐静脉标准化置管长度
性别-0.1000.0040.216-0.242
置管日龄0.385①0.0140.4070.520①
臂围0.782①0.385①0.824①
小腿围0.703①
置管时体重0.888①0.639①0.890①0.914①
), ArticleFig(id=1322530256066564128, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168410457359068, language=EN, label=Table 3, caption=

Simple linear regression analysis between standardized catheter placement length and body weight at catheterization

, figureFileSmall=null, figureFileBig=null, tableContent=
静脉类型常数项回归系数R²调整R²F值P
右贵要静脉6.9412.5620.7890.786265.7800.001
右肘正中静脉8.1102.1530.4080.23411.3660.001
右头静脉7.5832.5390.7910.77860.6820.001
右大隐静脉16.5743.9530.8360.832198.6860.001
), ArticleFig(id=1322530256125284385, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322168410457359068, language=CN, label=表3, caption=

标准化置管长度与置管时体重的简单线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
静脉类型常数项回归系数R²调整R²F值P
右贵要静脉6.9412.5620.7890.786265.7800.001
右肘正中静脉8.1102.1530.4080.23411.3660.001
右头静脉7.5832.5390.7910.77860.6820.001
右大隐静脉16.5743.9530.8360.832198.6860.001
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身体参数预测低出生体重儿不同静脉PICC标准化置管长度的临床研究
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王丽 , 谷美便 *, * , 李怡玮 , 郭佳莹 , 路燕荣
护理研究 | 综合研究 2026,40(6): 1004-1010
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护理研究 |综合研究 2026 , 40 (6) : 1004 -1010
身体参数预测低出生体重儿不同静脉PICC标准化置管长度的临床研究
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王丽，副主任护师，硕士研究生

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王丽, 谷美便*, * , 李怡玮, 郭佳莹, 路燕荣
作者信息
  • 1山西白求恩医院(山西医学科学院)，山西医科大学第三医院，同济山西医院，山西 030032
通讯作者:
谷美便，E-mail：
GU Meibian, E-mail:
作者简介:

王丽，副主任护师，硕士研究生

Clinical study on predicting standardised PICC line placement lengths for different veins in low birth weight infants based on body parameters
Li WANG, Meibian GU , Yiwei LI, Jiaying GUO, Yanrong LU
Affiliations
  • 1Shanxi Bethune Hospital/Shanxi Academy of Medical Sciences/Third Hospital of Shanxi Medical University/Tongji Shanxi Hospital, Shanxi 030032 China
    • Corresponding Author:
    GU Meibian, E-mail:
出版时间: 2026-03-25 doi: 10.12102/j.issn.1009-6493.2026.06.017
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摘要
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目的

分析低出生体重儿（LBWI）的经外周静脉置入中心静脉导管（PICC）标准化置管长度与身体参数的相关性，构建PICC标准化置管长度预测公式。

方法

选取2023年1月—2024年12月在山西白求恩医院新生儿重症监护室（ICU）接受右上肢及右下肢PICC的175例LBWI为研究对象，收集病人一般人口学资料（性别、置管日龄等）及置管资料［置管静脉、臂围（上肢置管时）、小腿围（下肢置管时）、置管时体重、标准化置管长度等］，采用Pearson相关分析探讨变量与各置管静脉标准化置管长度的相关性，基于简单线性回归分析结果构建LBWI不同静脉PICC标准化置管长度的预测公式，采用Bland-Altman图分析各静脉置管长度预测值与实际值间的一致性。

结果

右贵要静脉、右肘正中静脉、右头静脉、右大隐静脉标准化置管长度均与臂围、小腿围、置管时体重呈正相关（均P<0.05）；右贵要静脉、右大隐静脉标准化置管长度均与置管日龄呈正相关（均P<0.05），4种静脉的标准化置管长度与置管时体重相关性均最高。基于简单线性回归分析构建4个预测方程预测标准化置管长度，即右贵要静脉标准化置管长度=6.941+2.562×置管时体重（kg）；右肘正中静脉标准化置管长度=8.110+2.153×置管时体重（kg）；右头静脉标准化置管长度=7.583+2.539×置管时体重（kg）；右大隐静脉标准化置管长度=16.574+3.953×置管时体重（kg）。Bland-Altman图显示，4种静脉置管长度预测值与实际值间差值的均值较小，所有测量数据基本介于95%置信区间。

结论

低出生体重儿PICC标准化置管长度与置管时体重呈正相关，依据置管时体重构建的预测公式预测准确度较高。

经外周静脉置入中心静脉导管，PICC  /  低出生体重儿  /  置管长度  /  模型预测
Objective

To analyze the correlation between peripherally inserted central catheter(PICC) standardized catheterization length and body parameters in low birth weight infants(LBWI),and to construct a predictive formula for PICC standardized catheter placement length.

Methods

A total of 175 LBWIs who received PICC in the right upper limb or right lower limb in the neonatal intensive care unit of Shanxi Bethune Hospital were selected as research subjects from January 2023 to December 2024.General demographic data(gender,postnatal age at catheterization) and catheterization data[catheterization vein,arm circumference(for upper limb),calf circumference(for lower limb),body weight at catheterization,standardized catheter placement length] were collected.Pearson correlation analysis was used to explore the correlation between variables and standardized catheter placement length for each vein.Based on simple linear regression analysis results,predictive formulas for PICC standardized catheter placement length in different veins for LBWIs were constructed.Bland-Altman plots were used to analyze the agreement between predicted and actual insertion lengths for each vein.

Results

Standardized catheter placement lengths for the right basilic vein,right median cubital vein,right cephalic vein,and right great saphenous vein were all positively correlated with arm circumference,calf circumference and body weight at catheterization(all P<0.05).Standardized catheter placement lengths for the right basilic vein and right great saphenous vein were also positively correlated with postnatal age at catheterization(both P<0.05).Among all parameters,body weight at catheterization showed the highest correlation with standardized catheter placement length for all four veins.Based on simple linear regression analysis,four prediction equations were constructed to predict the standardized catheterization length. Standardized catheter placement length for right basilic vein=6.941+2.562×body weight at catheterization(kg).Standardized catheter placement length for right median cubital vein=8.110+2.153×body weight at catheterization(kg).Standardized catheter placement length for right cephalic vein=7.583+2.539×body weight at catheterization(kg).Standardized catheter placement length for right great saphenous vein=16.574+3.953×body weight at catheterization(kg).Bland-Altman plots showed that the mean differences between predicted and actual insertion lengths were small for all four veins,with almost all data points falling within the 95% confidence interval.

Conclusions

PICC standardized catheter placement length in LBWIs is positively correlated with body weight at catheterization.The prediction formulas based on body weight at catheterization demonstrate high accuracy.

peripherally inserted central catheter, PICC  /  low birth weight infant  /  catheter insertion length  /  model prediction
王丽, 谷美便, 李怡玮, 郭佳莹, 路燕荣. 身体参数预测低出生体重儿不同静脉PICC标准化置管长度的临床研究. 护理研究, 2026 , 40 (6) : 1004 -1010 . DOI: 10.12102/j.issn.1009-6493.2026.06.017
Li WANG, Meibian GU, Yiwei LI, Jiaying GUO, Yanrong LU. Clinical study on predicting standardised PICC line placement lengths for different veins in low birth weight infants based on body parameters[J]. Chinese Nursing Research, 2026 , 40 (6) : 1004 -1010 . DOI: 10.12102/j.issn.1009-6493.2026.06.017
正文
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低出生体重儿（low birth weight infant，LBWI）通常是指出生体重<2 500 g的新生儿。LBWI尤其是体重<1 500 g者，多存在器官发育不成熟，身体机能不完善，需长期通过经外周静脉置入中心静脉导管（PICC）进行静脉营养[1]。受个体解剖差异、静脉系统复杂性及非放射性定位局限，PICC病人易发生并发症，其中导管异位较常见，发生率为16.83%~29.60%[2]。黄海英等[3]对行PICC的150例早产儿进行研究后发现，18.67%的早产儿PICC置入过深，8.00%置入过浅。已有研究显示，PICC导管尖端过深易进入右心房，导致心律失常或心包积液/填塞；过浅停留在上/下腔静脉以外的小静脉，则会因高渗液稀释不足引发静脉炎、胸腔积液及腹膜腔渗液等并发症[4-5]。因此，准确预估PICC置入长度对于确保导管尖端定位于理想位置、减少并发症发生至关重要。传统PICC置入长度的预估方法为体表测量法，该方法操作简便，但准确性较低，尤其对于LBWI而言，微小误差即可导致导管尖端位置出现显著偏差[6]。目前已有研究者围绕身体参数构建基于不同置管静脉的最佳置管长度预测公式[3,7-9]，但多未充分考虑同一静脉左右侧肢体穿刺及不同体位对置管长度的影响，且穿刺点选择不统一或范围较大，同时预测公式所纳入的身体参数也各不相同，影响临床应用的精确性和简便性。本研究通过回顾175例LBWI的PICC资料，分析身体参数与置管长度间的相关性，构建标准化置管长度预测模型并进行验证，以期为临床提供更便捷、精准的置管长度预测方法。
1　对象与方法
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1.1　研究对象
选取2023年1月—2024年12月在山西白求恩医院新生儿重症监护室（ICU）接受右上肢及右下肢PICC的175例LBWI为研究对象。纳入标准：1）出生体重<2 500 g；2)导管留置时间>14 d；3）于上肢行PICC者X线定位显示PICC尖端位于第4胸椎至第6胸椎水平，上腔静脉与右心房交界处；于下肢行PICC者X线定位显示PICC尖端位于第8胸椎至第10胸椎水平，下腔静脉与右心房交界处[10]； 4）家属签署知情同意书。排除标准：1）有肢体畸形、血管畸形；2）X线显示导管尖端和心影右上缘、心影下缘显示不清；3）合并胸廓畸形、重度水肿等PICC禁忌证；4）合并严重感染、凝血功能异常等疾病；5）病历资料或PICC穿刺记录不完善。
1.2　研究指标及资料收集
收集病人一般人口学资料（性别、置管日龄等）及置管资料[置管静脉、臂围（上肢置管时）、小腿围（下肢置管时）、置管时体重、标准化置管长度等]。由2名具备置管资质的PICC专科护士按照标准流程[11]置入PICC，置管前操作人员测量病人臂围、小腿围，臂围为沿肩峰与尺骨鹰嘴连线中点的水平绕上臂1周测得，小腿围为沿小腿最粗部位（腓肠肌最饱满处）水平绕腿1周测得[12]。测量穿刺点沿静脉走行至肘横纹/踝关节的距离，记为A段，若穿刺点位于肘横纹/踝关节以下，A值为负数，反之为正数。置管后24 h内通过X线检查导管尖端位置，采用统一检查体位，即仰卧头部中位，上肢置管病人双上肢自然侧放于身体两侧，肘关节伸直；下肢置管病人仰卧膝关节屈曲，大腿与躯干纵轴成45°角，小腿与大腿成90°角蛙状[5,11,13]。当PICC尖端到达最佳解剖位置时，记录肘横纹/踝关节至PICC尖端长度，记为B段。基于A段、B段计算PICC标准化置管长度（A段+B段）。
1.3　研究材料及工具
1）PICC导管：选用优力捷公司生产的1.9Fr聚氨酯材质单腔导管，一体型，头端可裁剪。2）臂围/小腿围测量工具：选用优力捷公司PICC置管包内自带的不可伸缩量尺（宽1.6 cm、量程61.0 cm、分度值0.1 cm）。3）体重测量工具：使用电子婴儿秤（苏宏品牌），晨起08:00喂养前测量。
1.4　质量控制
置管操作人员每项指标测量3次取平均值。每日校准仪器，严格将测量误差控制在±0.2 cm（g）范围；由放射科医师床旁拍摄X线片并判读导管尖端位置。
1.5　统计学分析
采用IBM SPSS 29.0统计软件对数据进行统计分析。符合正态分布的定量资料以均数±标准差（x±s）表示；定性资料以频数和百分率（%）表示，采用Pearson相关分析评估变量间的相关性，通过简单线性回归分析探讨变量间的定量关系，并建立预测公式。构建Bland-Altman图，评价公式预测值与实际值间的一致性。以P<0.05为差异有统计学意义。
2　结果
收起
2.1　LBWI一般资料
175例LBWI的置管日龄为1~31 （7.0±4.1）d；置管时体重为0.76~2.30（1.26±0.25）kg；上肢置管134例，下肢置管41例。LBWI一般资料见表1。
2.2　标准化置管长度与不同临床参数的相关性
左侧贵要静脉组有效样本量为8例，小于自变量数的10倍（各置管静脉的简单线性回归分析均纳入1个自变量），不满足回归分析的样本量要求，因此，该静脉通路未纳入统计分析，标准化置管长度与不同临床参数的相关性见表2。
2.3　标准化置管长度与置管时体重的简单线性回归分析
以PICC标准化置管长度为因变量，Pearson相关分析中相关性最高的置管时体重为自变量，进行简单线性回归分析，结果见表3。根据回归模型结果，构建各置管静脉标准化置管长度的预测方程：右贵要静脉标准化置管长度=6.941+2.562×置管时体重（kg）；右肘正中静脉标准化置管长度=8.110+2.153×置管时体重（kg）；右头静脉标准化置管长度=7.583+2.539×置管时体重（kg）；右大隐静脉标准化置管长度=16.574+3.953×置管时体重（kg）。
2.4　置管长度预测值与实际值的比较
构建Bland-Altman图，4种置管静脉（右贵要静脉、右肘正中静脉、右头静脉、右大隐静脉）置管长度预测值与实际值间差值的均值较小（依次为0.012，-0.054，-0.022，0.080），所有测量数据基本介于95%置信区间（P>0.05）。见图1~图4。
3　讨论
收起
3.1　LBWI的PICC标准化置管长度与身体参数具有相关性
身体参数是新生儿生长发育的重要指标，已有研究发现，身体参数与新生儿PICC置管长度具有相关性，并基于胎龄、体重、身长等身体参数构建了不同置管静脉的PICC置管长度预测公式[3,8-9]。但以往研究多未充分考虑同一静脉左右侧肢体穿刺及不同体位对置管长度的影响，且穿刺点选择不统一或范围较大，预测效度存在局限性，同时不同研究预测公式纳入的身体参数也各不相同，一定程度上影响了临床应用的精确性和简便性。本研究Pearson相关分析结果显示，在性别、置管日龄、臂围、小腿围、置管时体重5类参数中，右贵要静脉、右肘正中静脉、右头静脉、右大隐静脉的PICC标准化置管长度与置管时体重的相关性均较高。体重是反映新生儿整体发育状况的关键指标，已有研究结果显示，不同体重的新生儿血管解剖结构存在差异，体重越小静脉越短，PICC标准化置管长度也需相应调整[14]。罗飞翔[15]研究发现，随着新生儿体重增长，PICC导管尖端会出现不同程度位移，体重增长40%、70%、100%时，导管尖端变浅约为2、3、4个椎体长度，导管尖端位置变化与体重增长相关（P<0.01），提示体重变化会影响导管位置，进而影响最佳置管长度。黄海英等[3]以出生体重为950~2 060 g的早产儿为研究对象，结果显示，不同置管静脉的PICC最佳置入长度和体重均呈正相关。新生儿体重测量简便、易操作，因此，可在新生儿PICC置管时以裸体重作为置管长度参考依据。
3.2　右贵要静脉和头静脉标准化置管长度与体重的相关性
本研究结果显示，右贵要静脉、右头静脉标准化置管长度均与置管时体重呈正相关，两条静脉的标准化置管长度预测公式与Kim等[16]研究结果相似，可能与两项研究对PICC最佳尖端位置的判定及拍片时体位的一致性有关。新生儿体位可影响导管尖端位置[5]，尤其是上下肢的内收外展会导致导管尖端移位，移位范围为1~4个肋间隙[17]。Nadroo等[18]研究指出，新生儿肢体运动，如肩内收、肘屈曲等，可造成PICC导管向心或离心位移，最大位移可达（15.11±1.22）mm。新生儿上腔静脉长度为1.4~2.3 cm[19]，体位变化极易导致上肢静脉置入的导管尖端移出上腔静脉或进入心脏[20]。因此，为保证尖端定位准确，本研究制定标准化操作流程，在X线拍片时保持新生儿体位一致，有利于避免导管尖端位置因体位变化造成误差。尽管预测公式结果相似，但本研究与Kim等[16]在体重范围0.25~2.50 kg内的置管长度仍存在一定差异，贵要静脉置管长度相差0.6~1.0 cm，头静脉置管长度相差0.5~1.0 cm。原因可能为：本研究聚焦于对右上肢静脉的预测，而Kim等[16]的研究则纳入了左上肢和右上肢静脉数据。此外，Luister等[21]研究也指出，在体长>32 cm的婴儿中，左上肢肘正中静脉、贵要静脉或头静脉的PICC置管长度比右上肢长，这一差异与上腔静脉在胸腔中的不对称位置相关，提示左、右上肢静脉的结构差异可能导致置管长度不同，未来研究中应进一步区分左、右上肢静脉，并分别建立置管长度预测公式。
3.3　右肘正中静脉标准化置管长度与置管时体重的相关性
本研究结果显示，右肘正中静脉标准化置管长度与置管时体重的相关性相对不高，与Luister等[21-23] 研究结果相似，可能与肘正中静脉向上汇入贵要静脉或头静脉，两种静脉路径的解剖差异可增加置管长度的变异性，从而削弱其与体重的相关性。因此，选择右肘正中静脉作为PICC置管静脉时，应充分认识到解剖路径变异可能对导管尖端定位和置管长度产生影响。为提高置管准确性，可结合其他评估辅助决策，以优化临床操作流程和效果。此外，本研究样本量偏小，可能导致回归模型的拟合度不足，需要进一步扩大研究样本，验证其低相关性的普遍性及潜在机制。
3.4　右大隐静脉标准化置管长度与置管时体重的相关性
本研究结果显示，右大隐静脉标准化置管长度与置管时体重呈正关系，与Chen等[23]研究结果相似，但Chen等[23]采用的是双侧大隐静脉的汇总数据，而本研究仅纳入右大隐静脉数据。Luister等[21]对右大隐静脉和左大隐静脉PICC置管长度的对比分析显示，二者差异无统计学意义（P<0.05）。提示大隐静脉置管长度的预测模型或可基于单侧数据进行构建，但该结论仍然需更大样本量的前瞻性研究进行验证。本研究与Armbruster等[22]（预测置管长度相差0.9~1.8 cm）及Kim等[16]（预测置管长度相差5.5~6.6 cm）研究结果相差较大，这一差异可能源于各研究选取的置管区域不同所致，Armbruster等[22]研究以踝关节上下1 cm范围为置管区域，Kim等[16]研究以腘窝为置管区域，而本研究以踝关节为参照点。提示在临床实践中采用明确且稳定的体表标志物（如踝关节）作为穿刺参照点，有利于避免因置管区域选择不当引起的误差。
3.5　PICC置管长度预测值与实际值间的一致性
右贵要静脉、右肘正中静脉、右头静脉、右大隐静脉的PICC置管长度预测值与实际值间差值均值较小，所有测量数据基本介于95%置信区间（均P>0.05），表明预测值与实际值间的一致性较高，公式预测准确度较高。
4　小结
收起
本研究对175例LBWI的PICC置管数据进行分析，结果显示，右贵要静脉、右肘正中静脉、右头静脉、右大隐静脉标准化置管长度与置管时体重间存在相关性，基于置管时体重的肘正中静脉置管长度预测公式效度相对较低，今后需进一步验证。但本研究也存在一定局限性，本研究为小样本回顾性研究，且样本量分布不均，建议之后扩大样本量，开展多中心、前瞻性研究，以验证预测公式的普适性和有效性。

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doi: 10.12102/j.issn.1009-6493.2026.06.017
  • 接收时间：2025-05-07
  • 首发时间：2026-10-28
  • 出版时间：2026-03-25
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  • 收稿日期：2025-05-07
  • 修回日期：2026-02-09
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    1山西白求恩医院(山西医学科学院)，山西医科大学第三医院，同济山西医院，山西 030032

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