骨内输液在危重症院前急救中的应用研究  

Study of application of intraosseous infusion in pre-hospital care for critically ill patients

作　　者：张剑峰[1] 梁俊雄[1] 梁俊杰[1] 吕博文[1] 刘华耀 

机构地区：[1]广东省江门市新会区人民医院急诊科,广东江门529100

出　　处：《中国现代医生》2013年第18期140-141,143,共3页China Modern Doctor

基　　金：广东省江门市2012年科技局科研项目(江科[2012]117号;序号1)

摘　　要：目的研究骨内输液在危重症院前急救中的可行性和有效性,探讨危重症院前急救输液的新方法。方法选择危重症院前急救建立外周静脉通道困难患者47例,随机分为治疗组(A组)24例以骨髓穿剌针建立骨内通道输液给药和对照组(B组)23例以头皮针建立外周静脉通道输液给药,其他救治措施两组均不受限制。观察比较两组建立输液通道耗时、输液速度、输液后血压恢复时间。结果建立输液通道耗时A组(2.4±0.9)min,B组(8.6±2.1)min,A组明显短于B组,两组比较差异有显著意义(P<0.01)。输液速度A组(12.7±3.6)mL/min,B组(4.5±2.3)mL/min,A组明显快于B组,两组比较差异有统计学意义(P<0.01)。输液后血压恢复时间A组(13.5±3.8)min,B组(23.3±3.9)min,A组明显快于B组,两组比较差异有显著意义(P<0.01)。结论在危重症院前急救中,骨内输液是外周静脉穿刺困难患者的替代方法,迅速、安全、有效、输液速度快符合急救要求,值得推广。Objective To study the feasibility and effectiveness of intraosseous infusion in the pre-hospital care for critically ill patients and explore the new methods of pre-hospital care for critically ill patients. Methods Forty-seven critically ill patients having difficulty in building peripheral intravenous access were randomly divided into the treat- ment group （group A） with 24 patients and the control group （group B） with 23 patients. Group A used the bone marrow puncture needle to build the intraosseous access for infusion medication and group B used the scalp acupunc- ture to establish the peripheral venous access for infusion. Other treatment measures in both groups were unrestricted. The infusion access building time, infusion rate and post-infusion blood pressure recovery time of the two groups were compared. Results The infusion access building time of group A was （2.4±0.9） minutes, which was significantly short- er than （8.6±2.1）minutes of group B, with significant difference between the two groups （P 〈 0.01 ）. The infusion rate of group A was （12.7±3.6） mL/minute, which was significantly faster than （4.5±2.3） mL/minute of group B, with significant difference between the two groups （P 〈 0.01 ）. The post-infusion blood pressure recovery time of group A was 13.5±3.8 minutes, which was significantly faster than （23.3±3.9）minutes of group B, with significant difference be- tween the two groups （P 〈 0.01 ）. Conclusion In the pre-hospital care for critically ill patients, intraosseous infusion is an alternative for patients with peripheral venous puncture difficulties. It is fast, safe and effective, has a fast speed and meets the emergency requirements, thereby worth promoting.

关 键 词：骨内输液 危重症 院前急救 骨内通道 外周静脉通道 

分 类 号：R605.971[医药卫生—急诊医学]