压力波形法与阻力消失法在硬膜外穿刺术中的应用比较  

Comparisons of sine pressure wave and lost of resistance during epidural catheter placement

作　　者：龚玉华[1] 石海霞[1] 武丽芳[1] 韩志强[1] 拉布旦白拉[1] 陈冬梅[1] 

机构地区：[1]内蒙古医学院附属医院麻醉科,呼和浩特市010050

出　　处：《临床麻醉学杂志》2011年第12期1190-1191,共2页Journal of Clinical Anesthesiology

摘　　要：目的比较压力波形法与阻力消失法在硬膜外穿刺术中的成功率。方法择期腹部外科手术拟行硬膜外麻醉患者400例,随机均分为压力波形组(P组)和阻力消失组(C组)。所有患者均采用直入法进针。P组在连续压力监测下施行穿刺;C组采用常规阻力消失法施行硬膜外穿刺。记录两组硬膜外穿刺时间、置管完成时间、穿刺成功率等,并记录压力波形变化。结果两组硬膜外穿刺时间、置管完成时间差异无统计学意义。P组穿刺成功率显著高于C组(100%vs.94%,P<0.01)。P组在针尖突破黄韧带时压力波形出现直线返折,继而出现正弦波形,确认针尖进入硬膜外腔。结论硬膜外穿刺中采用压力波形监测有助于提高穿刺成功率,且不延长操作时间。Objective To compare the success rate of pressure wave and lost of resistance during epidural catheter placement. Methods A total of 400 epidural anesthesia patients were randomly divided into 2 groups. Epidural catheter placement were comfirmed by sine pressure wave （ pressure dynamic graph, Group T, n= 200） or lost of resistance （Group C, n = 200） respectively. The time of epidural puncture, catheter placement, success rate were recorded. In addition, epidural pressure waves were also recorded. Results There was no significant difference in the time of puncture and catheter placement between the two groups. The success rate in group P was higher than that in group C（100% vs. 94%, P〈0. 01）. The tip of needle reaching epidural space was confirmed when the sine pressure wave became evident. Conclusion The success rate of epidural catheter placement can be increased by the sine pressure waveforrn without prolonging the procedure time.

关 键 词：硬膜外穿刺 压力波形监测 阻力消失法 

分 类 号：R614[医药卫生—麻醉学]