婴儿先天性心脏病纠治术前超声引导下桡动脉穿刺置管的效果  

Effect of Ultrasound-Guided Radial Artery Cannulation in Infants Undergoing Congenital Heart Defect-Corrective Surgery

作　　者：蒋莅 周志坚[1] 庄培均 王炫[1] 

机构地区：[1]复旦大学附属儿科医院麻醉科,上海201102

出　　处：《中国临床医学》2015年第3期418-420,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:比较采用超声引导法和触摸定位法对行先天性心脏病纠治术的婴儿进行桡动脉穿刺置管的操作时间、失败率及并发症情况。方法:将102例择期行先天性心脏病纠治手术的婴儿随机分为2组,A组(n=52)采用触摸定位法进行桡动脉穿刺置管,B组(n=50)采用超声引导法进行桡动脉穿刺置管。记录每例的穿刺时间、穿刺次数,比较各组首次穿刺成功的例数以及出现并发症的例数。结果:A组置管的平均时间[(8.9±7.5)min]明显长于B组[(4.9±3.7)min],P<0.05。B组首次穿刺成功的比例高于A组(78%比50%,RR=1.56)。A组共有8例出现动脉痉挛和(或)血肿,而B组仅有1例。结论:行先天性心脏病手术的婴儿在进行桡动脉穿刺置管时,超声引导法较触摸定位法可减少置管时间,提高穿刺成功率,减少并发症。Objective：To compare the time in demand,failure rate and complications of radial artery cannulation utilizing ultrasound guidance method in infants undergoing congenital heart defect-corrective surgery with that utilizing palpation positioning method.Methods：One hundred and two infants scheduled for congenital heart defect-corrective surgery were randomized into two groups,the group A（n=52）utilizing palpation positioning method for radial artery cannulation,and the group B（n=50）utilizing ultrasound guidance method for radial arterial cannulation.The time required for puncture,as well as the number of attempts for cannulation,was recorded.The number of successful first attempt and incidence of complications were compared between the groups.Results：The average duration of cannulation in group A（8.9±7.5）min is significantly longer than that in group B（4.9±3.7）min（P〈0.05）.The rate of successful first attempt in group B was higher than that in group A（78%vs50%,RR=1.56）.A total of 8 cases of artery spasm and/or hematoma appeared in group A,however,only 1 case in group B.Conclusions：The ultrasound guidance method,compared with the palpation positioning method,could reduce the duration of cannulation,improve the success rate of puncture and reduce the rate of complications,during the radial artery cannulation in infants undergoing congenital heart defect-corrective surgery.

关 键 词：超声引导 桡动脉穿刺 婴儿 先天性心脏病 

分 类 号：R726.1[医药卫生—儿科]