锁骨下深静脉置管术和股静脉置管术在危重病人抢救中的应用  

The comparing application of subclavian deep venipuncture and femoral vein catheter in the emergency rescue operation for critically ill patients

作　　者：陈巍[1] 杨家荣[1] 赖长征[1] 徐杨[1] 

机构地区：[1]成都市第三人民医院蒲江医院急诊科,四川蒲江611630

出　　处：《西部医学》2015年第4期625-627,共3页Medical Journal of West China

摘　　要：目的比较锁骨下深静脉置管与股静脉置管在急诊抢救急危重病人的应用效果。方法纳入2011年10月-2013年11月共62例行深静脉置管术患者,按穿刺置管方法不同分为两组,A组37例行股静脉置管术,B组25例行锁骨下深静脉置管术。比较两种深静脉置管术的首次穿刺成功率、置管完成时间、误穿动脉率、并发症、留置导管时间、导管相关感染率、深静脉血栓发生率、病人舒适度。结果股静脉置管术与锁骨下深静脉置管术相比,首次穿刺成功率高,置管完成时间短,误穿动脉率低,并发症少,组间比较差异有统计学意义（P〈0.05）,但导管相关感染率及深静脉血栓发生率高,病人舒适度差。结论临床若保留深静脉置管时间比较短（〈3天）,选择股静脉置管术简便、风险低、并发症少,对抢救急危重病人有临床应用价值;而对需较长时间深静脉置管患者,则选择锁骨下静脉置管较为合适。Objective To evaluate the application value of subclavian venipuncture and deep femoral vein venipuncture in the emergency rescue operation for critically ill patients. Methods 62 cases in our hospital, 37 were males and 25 were females,had deep venipuncture operation from October, 2011 to November,2013 were selected and divided into two groups, group A and group B, group A contained 37 cases with deep femoral vein venipuncture, group B contained 25 cases with subclavian venipuncture, comparing two deep venipuncture operation success rate of first puncture, the completion time of insertion, wear artery error rate, complications, indwelling catheter time, catheter related infection rate, incidence of deep vein thrombosis, patient comfort. Results Compared with subclavian deep venipuncture technique, deep femoral vein venipuncture had higher success rate of first puncture, shorter catheter completion time, lower wear artery error rate and fewer complications, the difference had statistical significance （P〈0.05）, but with higher rate of catheter related infection and deep vein thrombosis and less comfort. Conclusion With simple operation, lower risk and fewer complications, stocks venipuncture operation is suitable for short retaining deep venipuncture time （less than 3 days） and has clinical application value for the rescue of critically ill patients.

关 键 词：锁骨下深静脉置管术 股静脉置管术 急危重病人 

分 类 号：R472.9[医药卫生—护理学]