股静脉留置针在外周静脉穿刺困难休克患者急救中的应用研究  

Application of Femoral Venous Indwelling Needle in Rescuing Shock Patients with Peripheral Venipuncture Difficulty

作　　者：邱燕燕[1] 曹慧连 肖修稷 王齐芳 韩家裕 谢东阳[1] 

机构地区：[1]赣南医学院第二附属医院,江西信丰341600

出　　处：《赣南医学院学报》2016年第4期626-628,共3页JOURNAL OF GANNAN MEDICAL UNIVERSITY

摘　　要：目的:探讨股静脉留置针穿刺和中心静脉置管术在抢救外周静脉穿刺困难休克患者时的应用效果,找寻能迅速、有效的建立静脉输液通路的途径,从而提高抢救成功率。方法:将142例外周静脉穿刺困难休克患者随机分成实验组与对照组各71例。实验组采用留置针行股静脉穿刺输液,对照组经中心静脉置管建立输液通路。从穿刺时间、首次穿刺成功率、留置时间、并发症发生情况进行比较。结果:两组患者穿刺时间、留置时间比较差异有统计学意义(P<0.05)。实验组患者导管脱落的发生率高于对照组,而气胸、血栓形成、穿刺局部血肿的发生率均比对照组低,两组首次穿刺成功率、导管堵塞、误穿动脉的发生率比较差异无统计学意义(P>0.05)。结论:采用留置针行股静脉穿刺成功率高,所需时间短、并发症少,操作简便、易行,易于掌握;费用低廉,可替代中心静脉置管术在基层医院普遍推广用于外周静脉穿刺困难的休克患者的急救工作中。Objective： To study the effects of femoral venous indwelling needle and central venous catheterization in rescuing shock patients with peripheral venipuncture difficulty,and to find a quick and effective venous access in order to improve rescue success rate. Methods： Total 142 shock patients with peripheral venipuncture difficulty were randomized into the experimental group and control group,each including 71 patients. The experimental group received femoral venipuncture infusion with indwelling needle,and the control group received central venous catheterization to establish venous access. The puncture time,one-time puncture success rate,catheter indwelling time,and complications were compared between two groups. Results： There were significant differences between the two groups in puncture time and catheter indwelling time（ P〈0. 05）. The incidence of catheter shedding was higher in the experimental group than in the control group; the incidences of pneumothorax,thrombosis,and hematoma at puncture site were lower than in the control group;and there were no statistically significant differences between the two groups in one-time puncture success rate or the incidence of catheter occlusion,or undesirable artery penetration（ P〈0. 05）. Conclusion： Femoral venipuncture with indwelling needle had higher success rates,shorter working time,less complications,and simpler procedures,and lower cost. These advantages support its extensive use in place of central venous catheterization in the rescue of shock patients with peripheral venipuncture difficulty in primary hospitals.

关 键 词：留置针 股静脉穿刺 中心静脉置管 颈内静脉置管 休克 急救 

分 类 号：R472[医药卫生—护理学]