改良超声引导技术在无痛内镜患者行浅静脉置管中的应用  

Application of modified ultrasound guidance in catheterization of superficial venous in patients taking painless endoscopy

作　　者：李秀燕[1] 方桂珍 杨丹华[1] LI Xiuyan;FANG Guizhen;YANG Danhua(Department of Gastroenterology, the First Affiliated Hospital of Zhejiang Traditional Chinese Medicine University, Zhejiang Provincial TCM Hospital, Hangzhou 310000,China)

机构地区：[1]浙江中医药大学附属第一医院浙江省中医院消化科,浙江杭州310000

出　　处：《中国现代医生》2018年第9期111-114,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2015KYB270)

摘　　要：目的观察改良超声引导技术在无痛内镜患者行浅静脉置管中的指导效果,明确此应用对穿刺置管的安全性影响。方法将80例无痛内镜检查患者(BMI>27 kg/m^2)随机分为触摸组和超声组。触摸组采用传统的视觉加触摸法行浅静脉穿刺置管;超声组采用超声仪先查看浅静脉位置、走行及周围组织情况,然后采用先平面外定位穿刺再平面内引导的方法行浅静脉穿刺置管。记录并比较两组的一次穿刺成功率、穿刺失败率(穿刺三次未成功)、穿刺时间及并发症发生情况,以确定先平面外定位穿刺再平面内引导的超声技术在较肥胖患者行浅静脉穿刺置管中的指导作用及对患者检查治疗的影响。结果 (1)超声组一次穿刺置管成功率为82.5%,触摸组为43.5%,超声组高于触摸组(P<0.01)。(2)超声组穿刺置管时间为(12.175±5.217)s,触摸组为(24.8±21.472)s,超声组短于触摸组(P<0.01)。(3)超声组血肿和药物外渗发生率分别为2.5%和0%,触摸组均为10%,超声组并发症发生率小于触摸组(P<0.01)。结论用改良超声引导技术对较肥胖患者行浅静脉置管一次穿刺成功率高,穿刺时间短,并发症发生率低。Objective To observe the guiding effect of modified ultrasound guidance in superficial vein catheterization in patients taking painless endoscopy, and to clarify the effect of this application on the safety of catheterization. Methods Eighty patients with painless endoscopy（BMI〉 27 kg/m^2） were randomly divided into touch group（control group） and ultrasound group（experimental group）. In the touch group, the traditional visual plus touch method was used for superficial venous catheterization. In the ultrasound group, the position of the superficial vein and the surrounding tissue were observed firstly by using the ultrasound system and then punctured the superficial vein and set the pipe. Record and compare the success rate of one puncture, rate of puncture failure（three unsuccessful punctures）, puncture time and complications to determine the guiding role and the impact of patient examination and treatment of out-of-plane positioning puncture firstly and then in-plane guided ultrasonography in superficial vein puncture catheter of ICU shock patients. Results（1） The success rate of single puncture and catheterization in ultrasound group was 82.5%, which was 43.5% in touch group, it was higher than that in touch group（P〈0.01）.（2） The time of catheterization was（12.175±5.217） s in the ultrasound group,（24.8±21.472） s in the touch group, which was shorter in the ultrasound group than in the touch group（P〈0.01）.（3） The incidences of hematoma and drug extravasation in ultrasound group were 2.5% and 0%,respectively, and those in touch group were both 10%. The incidence of complications in ultrasound group was smaller than that in touch group（P〈0.01）. Conclusion The improved ultrasound guided technique has the advantages of high success rate, short puncture time and low complication rate in obese patients.

关 键 词：浅静脉置管 改良超声引导技术 无痛内镜 

分 类 号：R472[医药卫生—护理学]