表面麻醉对桡动脉穿刺患者动脉血气影响的研究  

Research of the influence of topical anesthesia on artery courage vigor for patients with radial artery puncture

作　　者：夏玲[1] 赵宏胜[1] 王忠勇[1] 吴娟[1] 丁敏[1] 

机构地区：[1]南通大学附属医院,江苏南通226001

出　　处：《护士进修杂志》2009年第10期872-874,共3页Journal of Nurses Training

基　　金：江苏省南通市社会发展科技计划指令性项目(编号:S2007034)

摘　　要：目的研究利多卡因表面麻醉对桡动脉穿刺患者动脉血气的影响。方法选择符合病例标准的桡动脉穿刺患者100例,随机分为两组,两组首次穿刺采用传统法,第二次穿刺采用配制2%利多卡因无菌棉片湿敷法,甲组(n=50)在桡动脉穿刺前5 min湿敷,乙组(n=50)在桡动脉穿刺前10 min湿敷,评估视觉模拟量表(VAS)和Wong-baker面部表情量表评分变化;比较两组患者pH值、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、呼吸频率(R)及心率(HR)的变化。结果与甲组比较,乙组患者的视觉模拟量表(VAS)和Wong-baker面部表情量表两项疼痛评分指标均显著降低,差异有显著意义(P<0.001);心率、呼吸的变化差值下降,差异有显著意义(P<0.01);动脉血氧分压(PaO2)下降,二氧化碳分压(PaCO2)升高,差异有显著意义(P<0.001)。结论桡动脉穿刺前10 min采用2%利多卡因浸湿的无菌棉片湿敷,既能减轻患者穿刺疼痛,又能稳定心率,有效地保持血气分析参数的相对稳定,是一种比较安全的无痛穿刺方法。Objective To study the influence of Lidocaine topical anesthesia on artery courage vigor for patients with radial artery puncture. Method 100 patients with radial artery punctures conformed to the case standard were selected and randomly divided into two groups, first puncture of two groups used the traditional way, while the second used 2% Lidocaine aseptic cotton and kapok piece spread wet, the starting team （n=50） spreads wet in the first 10 minutes before radial artery puncture, the second division （n= 50） spreads wet in the first 5 minutes before radial artery puncture. Evaluating visual simulation meter （VAS） and Wong-baker facial expression meter; and compared with the change of patients pH value, artery blood oxygen partial pressure （PaO2）, artery blood carbon dioxide differential pressure （PaCO2）, respiratory rate （R） and heart rate （HR） in the two groups. Result Compared with the starting team, the two ache grading targets as patients VAS objective grading and Wong-baker subjedtive grading of the second division have obviously reduced, it has statistical significance （P〈0. 001）. The change of heart rate and the breath drops also has statistical significance （P〈0.001）. The artery blood oxygen partial pressure （PaO2） drops, the carbon dioxide differential pressure （PaCO2） increased. It has statistical significance as well （P〈0.001 ）. Conclusion In the first 10 minutes before the radial artery puncture, using the aseptic cotton and kapok piece soaked by 2% Lidocaine to spread wet, it can reduce the ache of patients, stabilize the heart rate and maintain the relative stabilization of the courage vigor analysis parameter. It is an safe and indolent puncture method.

关 键 词：利多卡因 桡动脉穿刺 血液动力学现象 护理 

分 类 号：R472[医药卫生—护理学]