超声定位法在腋静脉穿刺中的安全性评价  

Safety evaluation of ultrasound location in axillary venipuncture

作　　者：刘孜卓 柴艳芬[1] 寿松涛[1] 黄立权[2] Liu Zizhuo;Chai Yanfen;Shou Songtao;Huang Liquan(Emergency Department,Tianjin Medical University General Hospital,Tianjin 300052,China;Intensive Care Unit,the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310006,China)

机构地区：[1]天津医科大学总医院急诊医学科,300052 [2]浙江中医药大学附属第一医院ICU,杭州310006

出　　处：《中华急诊医学杂志》2019年第12期1520-1523,共4页Chinese Journal of Emergency Medicine

基　　金：协和睿E急诊医学研究专项基金(R2017016)。

摘　　要：目的探讨超声定位法同体表定位(Magney)法腋静脉穿刺置管的成功率和安全性。方法选取2017年1月至2018年9月本院EICU患者,共纳入患者80例,随机(随机数字法)分为Magney法(n=35)和超声引导法(n=45)。统计穿刺成功次数、成功率和并发症情况。结果Magney定位法同超声定位法比较,1次成功率(25.7%vs 68.9%,P<0.01)、穿刺大于2次(34.3%vs 11.1%,P=0.012)及总成功率(82.9%vs 100%,P=0.004),差异有统计学意义。两种穿刺方法均有误穿动脉,差异无统计学意义。Magney定位法发生血肿2例,臂丛神经损伤1例,48 h内未发生感染;超声定位法未发生并发症。结论超声定位法腋静脉穿刺是一种安全有效的中心静脉置管方法,较体表定位(Magney)法有更高的成功率和安全性。Objective To explore the success rate and safety of axillary venipuncture catheterization with ultrasound localization and homologous surface localization(Magney).Method A total of 80 patients were enrolled in the EICU from January 2017 to September 2018.They were randomly assigned to the Magney method(n=35)and the ultrasound-guided method(n=45).The number of successful punctures,success rate and complications were recorded.Results Compared with ultrasound-guided method,the one-time success rate(25.7%vs 68.9%,P<0.01),puncture greater than 2 times(34.3%vs 11.1%,P=0.012),and total success rate(82.9%vs 100%,P=0.004)in Magney method were significantly different.Both of the two puncture methods were mis-invasive,and the difference was not statistically significant.In Magney method 2 patients occurred hematoma and 1 patient brachial plexus injury,but no infection occurred within 48 h.While no such occurrence was found in ultrasound-guided method.Conclusion Ultrasound-guided method axillary venipuncture is a safe and effective method of central venous catheterization,which has higher success rate and safety than Magney method.

关 键 词：腋静脉 中心静脉置管 超声 并发症 Magney法 

分 类 号：R47[医药卫生—护理学]