改良股静脉留置针穿刺法在危重患者抢救中的应用效果观察  

Effect of modified puncturing of indwelling needle in femoral vein in critically ill patients

作　　者：韩淑贞[1] 张利岩[1] 高歌[2] 杨玉凤[3] 林红兰[4] 

机构地区：[1]中国人民武装警察部队总医院护理部,北京100039 [2]中国人民武装警察部队总医院干一科,北京100039 [3]中国人民武装警察部队总医院颌面外科,北京100039 [4]中国人民武装警察部队总医院南三科,北京100039

出　　处：《中国急救复苏与灾害医学杂志》2010年第4期344-346,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的评价危重患者抢救时股静脉留置针穿刺的成功率和穿刺并发症的发生率。方法将重症监护病房（ICU）286例需快速建立静脉通路进行抢救的急、危重患者随机均分为实验组和对照组，实验组采用改良股静脉留置针穿刺法，对照组采用传统方法穿刺。观察并比较一次穿刺成功率、误穿动脉及局部血肿发生率，以及穿刺完成时问。结果实验组与对照组相比，一次穿刺成功率更高、穿刺并发症率更低，穿刺完成时间更短（均P〈0．01）。结论改良股静脉留置针穿刺法，简便快捷，能有效提高穿刺成功率，降低并发症的发生。Objective To evaluate the effect of modified puncturing of indwelling needle in femoral vein in critically ill patients. Methods 286 intensive care unit （ICU）patients in need of immediate establishment of intravenous access for emergency treatment were randomly divided into 2 equal groups： experimental group undergoing modified puncturing of indwelling needle in femoral vein （use the middle finger pulp of the left hand to touch the place with the most obvious pulsation of femoral artery, move the index, middle, and ring fingers along the artery downwards for a distance of the width of the 3 fingers, and push the artery outwards, then insert the puncture needle into the femoral vein at the point 0.5-0.8 cm inside the tips of the 3 fingers towards the direction of heart at an angle of 30°-45° to the skin） and control group undergoing puncture with traditional method. The success rate of puncture, incidence of mistaken puncturing of artery, incidence of local hematoma, as well as the completion time of puncturing were observed. Results The success rate of one-time puncturing of the experiment group was 89. 51%, signifieantly higher than that of the control group （ 64. 34%, P〈 0.01）. The puncturing time of the experimental group was （1.54±0.55） min, significantly shorter than that of the control group [（3.85 ±2.66）min, P〈 0.01]. The rate of mistaken puncturing of femoral artery and hematoma of the experimental group were 4.90% and 4. 20% respectively, hoth significantly lower than those of the control group （ 13.29% and 18. 18% respectively, both P 〈 0.01）. Conclusion Simple to operate and quick to complete, the method of modified puncturing of indwelling needle into femoral vein heightens the success rate of puncturing and decreases the complication rate.

关 键 词：股静脉 静脉留置针 穿刺法 

分 类 号：R472[医药卫生—护理学]