目的 探讨早产儿经外周中心静脉置管（PICC）的最佳穿刺部位。方法 对162例早产儿在不同部位行PICC穿刺，根据穿刺部位分为肘部静脉穿刺组（n=66）、腋静脉穿刺组（n=39）和膝关节内侧大隐静脉穿刺组（n=57），比较各组间导管一次穿刺到位率、非计划拔管率和非计划拔管导管留置时间的差异，并分析非计划拔管的主要原因。结果 肘部静脉组、腋静脉组和大隐静脉组导管一次穿刺到位率分别为92.42%、94.87%和91.23%，导管留置期间非计划拔管率分别为18.18%、10.26%和17.54%，非计划拔管导管留置时间分别为（22.25±21.10）、（28.5±15.42）和（22.2±4.06）d，组间差异均无统计学意义（P>0.05）。导致早产儿非计划拔管的主要原因为堵管。结论 经不同部位对早产儿行PICC穿刺，穿刺成功率相近，非计划拔管率和非计划拔管导管留置时间均相近。当临床上常用的PICC穿刺部位静脉不具备穿刺条件时，腋静脉、大隐静脉也可作为首选穿刺静脉，且经腋静脉置入PICC更显示一定优势，为早产儿经外周静脉建立中心静脉通路增加了合适的操作部位。

Objective To investigate the best puncture site of peripherally inserted central catheter (PICC) for premature infants. Methods A total of 162 preterm infants who underwent PICC were divided into three groups according to their puncture sites, i.e. the elbow vein puncture group (n=66), axillary vein puncture group (n=39), and knee medial saphenous vein puncture group (n=57). The one-step success puncture rate, unplanned cupping rate, and catheter indwelling time before unplanned cupping of three groups were compared and main reason of unplanned cupping was analyzed. Results The one-step success puncture rates of elbow vein, axillary vein, and knee medial saphenous vein puncture groups were 92.42%, 94.87%, and 91.23%, respectively. The unplanned cupping rates of three groups were 18.18%, 10.26%, and 17.54%. The catheter indwelling time before unplanned cupping of three groups was (22.25±21.10)d, (28.5±15.42)d, and (22.2±4.06)d. The differences of three groups were not statistically significant (P>0.05). The main reason for unplanned cupping was tube plugging. Conclusion For PICC at different sites of premature infants, the one-step success puncture rate, unplanned cupping rate, and catheter indwelling time before unplanned cupping are similar. When the vein at commonly used puncture site is unable to perform PICC, the axillary vein and great saphenous vein can also be used for vein puncture and inserting PICC through the axillary vein shows certain advantages. The study provides more suitable sites for premature infants to establish central venous access through peripheral vein.