超声定位法与触摸法桡动脉穿刺置管在感染性休克患者中的临床应用比较  

Comparison of Clinical Application of Ultrasound Localization Method and Palpation Method on Radial Artery Puncture and Catheterization in Patients with Septic Shock

作　　者：周泓旭[1] 田阿勇[1] 方波[1] 马虹[1] 

机构地区：[1]中国医科大学附属第一医院麻醉科,沈阳110001

出　　处：《中国医科大学学报》2017年第3期258-260,265,共4页Journal of China Medical University

摘　　要：目的比较2种不同桡动脉穿刺置管方法在感染性休克患者中的应用。方法选取感染性休克并需行急诊手术患者80例(休克指数>1.0)。采用随机数字表法,将患者随机分为超声组(U组)和触摸组(A组),每组40例。U组使用Sonosite SNerve超声在腕部确定桡动脉位置并进行穿刺,A组以触摸法确定桡动脉位置并进行穿刺。记录2组患者穿刺前心率和血压、一次穿刺成功率、总成功率、穿刺次数、穿刺时间和并发症发生率。结果与A组比较,U组一次穿刺成功率、总成功率显著提高,穿刺次数显著减少,穿刺时间显著缩短,并发症发生率显著降低(P均<0.05)。结论应用超声对感染性休克患者行桡动脉穿刺置管定位准确,一次穿刺成功率和总成功率高,穿刺次数少,穿刺时间短,并发症发生率低。Objective To compare the application of two different radial artery puncture and cannulation methods in septic shock patients. Methods A total of 80 septic shock patients who need emergency operation were enrolled in this study. The shock index was 1.0. The patients were randomly divided into two groups：ultrasound group（group U）and palpation group（group A）,with 40 cases in each group. For the patients in group U,Sonosite S-Nerve ultrasound in the wrist was used to determine the location of the radial artery puncture. For the patients in group A,palpation method was used to determine the location of the radial artery puncture. The heart rate,blood pressure,first puncture success rate,total success rate,number of punctures,puncture time and complication rate of the two groups were monitored. Results The success rate of first puncture and total success rate of group U were higher than those of group A,the number of puncture was less than that of group A,the puncture time was shorter than that of group A,and the incidence of complications was lower than that of group A（P〈0.05）. Conclusion The application of ultrasound for radial artery puncture and catheterization in septic shock patients is accurate,and with higher first success puncture rate and total success rate,less number of puncture,shorter puncture time,and lower incidence of complications compared with palpation method.

关 键 词：超声 桡动脉 感染性休克 

分 类 号：R614.2[医药卫生—麻醉学]