超声引导下平面内与平面外技术进行术中动脉穿刺置管研究  

Ultrasound-guided in-plane and out-of-plane approaches for intraoperative artery cannulation

作　　者：聂明辉[1] 张晓侠[2] 刘会玲[1] 李义学[1] 王晓岩[1] 吴文瑛[1] 冯佩明[1] NIE Minghui;ZHANG Xiaoxia;LIU Huiling;LI Yixue;WANG Xiaoyan;WU Wenying;FENG Peiming(Department of ultrasound,Affiliated Hospital of Chengde Medical University Chengde 067000 China;Department of Anesthesiology, Affiliated Hospital of Chengde Medical University Chengde 067000 China)

机构地区：[1]承德医学院附属医院超声科 [2]承德医学院附属医院麻醉科,河北承德067000

出　　处：《现代仪器与医疗》2017年第2期46-48,共3页Modern Instruments & Medical Treatment

基　　金：承德市科学技术研究与发展计划项目;编号201606A027

摘　　要：目的:探讨超声引导下平面内技术与平面外技术在术中动脉穿刺置管中的应用。方法:选择我院2015年7月~2016年8月择期手术患者122例,随机分为平面内技术组(A组,n=62)和平面外技术(B组,n=60)。A、B两组患者分别在超声引导下采用平面内技术和平面外技术进行桡动脉穿刺置管。记录每组患者超声定位时间、总穿刺时间、穿刺次数,首次穿刺成功例数及首二次穿刺成功例数,并分别于穿刺前(T1)和拔管后0.5h(T2)测量穿刺点桡动脉内径、桡动脉收缩期血流峰值流速及穿刺侧的无创动脉血压,记录两组患者并发症的发生情况。结果:两组患者总穿刺时间和穿刺次数相比差异无统计学意义,A组患者超声定位时间长于B组、首次成功穿刺例数少于B组,差异有统计学意义,P<0.05,但A组患者首二次穿刺成功率显著高于B组,差异有统计学意义,P<0.05;组内比较:两组患者T1时刻的桡动脉内径均大于T2时刻且桡动脉收缩期血流峰值流速均低于T2时刻,差异有统计学意义,P<0.05,两组患者T1和T2时刻MAP相比,差异无统计学意义;组间比较:T1和T2时刻两组患者桡动脉内径、收缩期血流峰值流速、MAP相比差异无统计学意义;A组患者血肿和桡动脉后壁穿透的发生率明显低于B组患者,差异有统计学意义,P<0.05。结论:平面内技术和平面外技术引导动脉穿刺置管对桡动脉血流动力学影响相似;与平面外技术相比,平面内技术超声定位时间长,但其首二次穿刺成功率高,并发症少。Objective:This study was designed to explore the application of ultrasound-guided in-plane and outof-plane approaches for intraoperative artery cannulation.Methods:A total sampale of122patients who underwentelective surgery from July2015to August2016were randomly divided into in-plane group(group A,n=62)and out-ofplanegroup(group B,n=60).The patients of group A and group B underwent radial artery cannulation with ultrasoundguidedin-plane and out-of-plane approaches.The length of ultrasonic positioning,the times of cannulation attempts,the total duration of cannulation,success rates at first-time attempt and the first two attempts were recorded.The radialartery diameter and peak systolic velocity,and noninvasive arterial blood pressure on the puncture side were measuredat the points for cannulation before cannulation(T1)and0.5h after extubation(T2).The complication of the two groupswas recorded.Results:There was no significant difference the total duration of cannulation and the times of cannulationattempts between the two groups.The length of ultrasonic positioning of group A was longer than that of the group B,the success rate at first-time attempt was less than that of the group B,the difference was statistically significant(P<0.05),but the success rate at the first two attempts was significantly higher in group A than in group B.Compared with T2,the radial artery diameter of both two groups was greater at T1,and the peak systolic velocity of radial artery of bothtwo groups was lower than that of T2,the difference was statistically significant(P<0.05).There was no significantdifference in MAP between the two groups at T1and T2.There was no significant difference in the radial artery diameter and peak systolic velocity,and MAP between the two groups of patients at T1and T2.The incidence of hematoma and wallpenetrating of radial artery in group A was significantly lower than those in group B,the difference was statistically significant(P<0.05).Conclusions Ultrasound-guided in-plane and out-of-plane approaches for

关 键 词：超声引导 平面内技术 平面外技术 桡动脉穿刺 

分 类 号：R445.1[医药卫生—影像医学与核医学]