目前新生儿PICC尖端定位的方法主要有体表测量法、X线尖端定位法、B超引导辅助定位和静脉腔内心电图定位.前3种方法分别存在局限性:个体生理结构的差异可能会影响体表测量结果的准确性;不同观察者采用影像学定位可能存在视觉和主观判断上的差异,且患儿易受到X线辐射;B超引导辅助定位不能显示导管的全程,对一些在中心静脉内打折或导管尖端过深的病例无法进行判断.腔内心电图定位技术通过观察置管过程中心电图上P波的特征性变化判断导管尖端位置,可在置管过程中及时定位,减少导管尖端位置不正确而引发的风险,避免术后行X线带来的辐射和术后再次调管,降低检查费用.本文从新生儿PICC尖端定位的方法、腔内心电定位技术的原理、研究现状、先进性及局限性等方面进行综述.

目的 探讨品管圈活动降低早产儿肺部感染发生率的应用效果。 方法 成立品管圈，确立降低早产儿肺部感染发生率为活动主题，进行现况调查，要因分析，遵循PDCA流程，依据5W1H原则制定对策并实施。 结果 早产儿肺部感染发生率由活动前的15.69%下降到活动后的1.85%（P<0.05）；圈员在解决问题能力、团队精神、沟通协调能力、责任心、工作积极性等方面取得进步。 结论 品管圈活动可有效降低早产儿肺部感染发生率，从而降低新生儿医院感染的发生，增加了团队凝聚力，提升了新生儿医护人员解决问题的能力。

Objective:To explore the effect of family participation management model on family needs and nursing ability of premature infants.Methods:The families with infants born in our hospital and in line with inclusion and exclusion criteria were set as the research objects.They were divided into experimen-tal group and control group according to whether family members participated in the family nursing.At the time of enrollment and two weeks after , the criti-cal care family needs inventory and neonatal nursing competency questionnaire were completed , and the implementation effect of family participation man-agement model was compared.Results:The difference of the general situation and family status of the infants was not statistically significant between the ex-perimental group and the control group.The family needs of the two groups were at a high level.After the implementation of family participation manage-ment model, the medical staff support, the needs of information access and a close relationship with the infants in the experimental group were reduced com-pared with those in the control group.The need of disease assurance was the same between the two groups and the need of comfort in the experimental group was higher than that in the control group.The neonatal nursing ability and satisfaction of the medical team were higher in the experimental group than those in the control group.Conclusion:The implementation of family participation management model can effectively meet the needs of family members of prema-ture infants, and improve nursing ability and satisfaction.