不同超声引导平面技术在肝脾破裂手术患者有创动脉血压监测置管中的应用  

Application of different ultrasound guided plane technology in invasive arterial blood pressure monitoring catheter for the liver and spleen rupture surgical patients

作　　者：聂明辉[1] 张晓侠[1] 刘会玲[1] 李义学[1] 王晓岩[1] 吴文瑛[1] 冯佩明[1] 丁华杰[1] 王志学[1] 赵胜军[2] NIE Ming-hui;ZHANG Xiao-xia;LIU Hui-ling;LI Yi-xue;WANG Xiao-yan;WU Wen-ying;FENG Pei-ming;DING Hua-jie;WANG Zhi-xue;ZHAO Sheng-jun(Affiliated Hospital of Chengde Medical University, Hebei, Chengde , Chin)

机构地区：[1]承德医学院附属医院,河北067000 [2]承德市中心医院

出　　处：《中国地方病防治》2017年第7期796-796,798,共2页Chinese Journal of Control of Endemic Diseases

基　　金：承德市科学技术研究与发展计划项目(201606A027)

摘　　要：目的观察并比较长轴平面内、短轴平面外超声引导平面技术在肝脾破裂手术患者有创动脉血压监测置管中的应用价值。方法选取本院180例接受手术治疗的肝脾破裂患者,分为长轴组、短轴组,各90例,均于术后实施有创动脉血压监测,长轴组于超声长轴平面内引导下行穿刺置管,短轴组于超声短轴平面外引导下行穿刺置管,比较两种技术的效果与安全性。结果长轴组刺入目标血管时间、总穿刺时间、1次穿刺成功率高于短轴组,其穿刺次数低于短轴组(P<0.05)。长轴组、短轴组并发症发生率分别为7.78%、8.89%(P>0.05)。两组患者置管后6 h SBP、DBP均较置管前上升,其动脉乳酸、去甲肾上腺素用量均下降(P<0.05),长轴组、短轴组置管后6 h生命体征组间比较(P>0.05)。结论两种超声引导平面技术均有着良好的安全性,长轴平面内技术具有穿刺成功率高的优势,但穿刺时间较长,进一步优化长轴平面内引导技术有望缩短穿刺时间,为该技术的推广奠定基础。Objective To observe and compare the application value of long axis plane,short axis plane guided by ultrasound plane technology in invasive arterial blood pressure monitoring catheter for the liver and spleen rupture surgical patients.Methods A total of 180 cases of the liver and spleen rupture surgical patients treated in our hospital were selected,who were equally divided into the long axis group and the short axis group and given the invasive arterial blood pressure monitoring after operation.The long axis group were applied the arterial puncture catheter guided by ultrasound long axis plane,and the short axis group patients were given the arterial puncture cathete,the effect was compared.Results Puncture time for target vessel and total puncture,and the one-time successful puncture rate were higher than that of the short axis group,but the puncture times were obviously fewer（ P0.05）. The occurrence of complications rate for the long axis group was 7.78%,while the rate for the short axis group was 8.89%（ P0.05）. The SBP and DBP were higher after catheterization for the patients of two groups after 6 h,while the arterial lactic acid and the dose change of norepinephrine had decreased（ P〈0.05）. We compared the vital signs after 6 h of these two groups（ P〉0.05）.Conclusions These two methods both have high safety. The long axis plane has a higher successful puncture rate but the total time of puncture is longer. A further optimizing of shorten the puncture time for long axis plane guided by ultrasound may pave the way for disseminating of this new technology.

关 键 词：超声引导 肝脾破裂 有创动脉血压监测 穿刺置管 

分 类 号：R445.1[医药卫生—影像医学与核医学]