动静脉留置针用于抢救失血性休克的临床研究  

（3inicai study of Arteriovenous needle used in rescuing patients with hemorrhagic shock

作　　者：柯纬祺[1] 王玉婷[1] 郭绪铿[1] 纪璇[1] 程明华[1] Ke Weiqi Wang Yuting Guo Xukeng Ji Xuan Cheng Minghua(Department of Anesthesiology, the First Affiliated Hospital of Medical College of Shantou University, Shantou, Guangdong 515041, China)

机构地区：[1]汕头大学医学院第一附属医院麻醉科,广东省汕头515041

出　　处：《中国基层医药》2017年第21期3233-3236,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的评估16G动静脉留置针经锁骨上入路锁骨下静脉穿刺置管用于急诊抢救失血性休克的临床价值，为临床快速建立深静脉通道提供新思路。方法选择急性失血性休克患者80例，采用随机数字表法将患者分为动静脉留置针组（留置针组）和常规导引丝深静脉穿刺组（常规穿刺组），每组40例，两组均经锁骨上入路行锁骨下静脉穿刺置管，观察两组患者的操作时间、首次穿刺成功率、穿刺次数以及补液速度，并随访并发症发生情况。结果留置针组的操作时间为（62±22）g，明显短于常规穿刺组的（672±178）s，两组差异有统计学意义（t=15．062，P=0．000）；留置针组首次穿刺成功率为70％（28例），常规穿刺组成功率为80％（32例），两组穿刺成功率差异无统计学意义（x2=1．067，P=0．439），所有患者均在尝试3次内穿刺成功；输注500mL羟乙基淀粉时留置针组的补液速度为（198±51）S，优于常规穿刺组的（456±86）s，两组差异有统计学意义（t=9．318，P=0．000）；两组患者穿刺过程及随访中均未发生深静脉穿刺相关并发症。结论动静脉留置针经锁骨上入路锁骨下静脉穿刺置管与常规导引丝锁骨上入路锁骨下静脉穿刺置管均可用于急诊抢救失血性休克患者，但留置针组在操作时间和补液速度上优于常规导引丝组，更适用于抢救时间紧迫的急性失血性休克患者，待患者循环稳定后可再经套管针置入导引丝留置锁骨下静脉导管。Objective To evaluate the clinical value of subclavian vein puncture with 16 G arteriovenous indwelling needle for emergency treatment of hemorrhagic shock, so as to provide a new approach for the rapid establishment of deep venous passage. Methods 80 patients with acute hemorrhagic shock were randomly divided into patients with arteriovenous indwelling needle group （catheter group） and conventional guide wire deep vein puncture group（ routine puncture group） ,40 cases in each group. The two groups were treated with supraclavicular subclavian vein puncture. The operation time, success rate of the first puncture, puncture times and rehydration rate, incidence of complications were observed in the two groups. Results The operation time of indwelling needle group was （62 ± 22 ）s, which was significantly shorter than （672 ± 178 ）s of the conventional puncture group, there was significant difference between the two groups（t = 15. 062,P = 0.000）. The first time success rate of puncture in the indwelling needle group was 70% （28 cases）, which in the conventional group was 80% （ 32 cases）, the difference was not statistically significant（ x2 = 1. 067, P = 0. 439 ）, all patients were in 3 attempts in successful puncture. The velocity of infusion of 500 mL hydroxyethyl starch in the indwelling needle group was （198 ±51 ）s,which was better than （456 ± 86）s in the conventional puncture group, the difference between the two groups was statistically significant （t = 9.318 ,P = 0. 000）. The two groups had no deep vein puncture related complications. Conclusion Arteriove- nous indwelling needle by supraclavicular subclavian vein puncture with conventional guide wire supraclavicular subclavian vein puncture catheter can be used for emergency treatment of hemorrhagic shock, but the indwelling needle group in the operation time and velocity is superior to conventional guide wire group, more suitable for the rescue of patients with acute hemorrhagic shock time is pressing, stay with st

关 键 词：注射 静脉内 注射 动脉内 静脉穿刺术 锁骨下静脉 休克 出血性 

分 类 号：R473[医药卫生—护理学]