骨髓腔穿刺建立血管通路技术在创伤失血性休克患者救治中的临床研究  

Clinical study on the establishment of vascular access technique through marrow cavity puncture in the treatment of patients with traumatic hemorrhagic shock

作　　者：胡鸿宇[1] 夏森林[1] 许岚[1] 姚晓丽[1] HU Hongyu;XIA Senlin;XU Lan;YAO Xiaoli(Department of Acute and Critical Medicine,Huzhou Central Hospital in Zhejiang Province,Affiliated Cent Hospital Huzhou University Huzhou,313000,China)

机构地区：[1]浙江省湖州市中心医院湖州师范学院附属中心医院急诊医学科,浙江湖州313000

出　　处：《中国现代医生》2020年第10期11-14,共4页China Modern Doctor

基　　金：浙江省医药卫生技术成果项目(2018ZH041);浙江省湖州市公益性应用研究项目(2019GY05,2017GYB34)。

摘　　要：目的探讨骨髓腔穿刺(IO)建立血管通路技术在创伤失血性休克患者救治中的临床应用效果。方法选择2016年1月~2018年12月浙江省湖州市中心医院收治的创伤失血性休克患者66例,其中2016年1月~2017年6月的32例采用中心静脉穿刺建立输液通路治疗的患者纳入对照组,2017年7月~2018年12月的34例采用经骨髓腔穿刺建立血管通路治疗的患者纳入IO组,两组患者建立好输液通路后,观察两组患者的一次性穿刺成功率,成功建立血管通路的时间及血压开始回升的时间,并观察24 h的抢救有效率。结果IO组患者的一次性穿刺成功率为100.0%,较对照组的53.1%明显升高,差异有统计学意义(P<0.05);IO组的建立输液通道时间为(1.7±0.8)min,较对照组的(7.2±2.8)min明显降低,差异有统计学意义(P<0.05);IO组的血压回升时间为(7.3±2.4)min,较对照组的(17.6±4.5)min明显降低,差异有统计学意义(P<0.05);IO组的24 h抢救有效率为91.2%,较对照组的75.0%明显增高,差异有统计学意义(P<0.05)。结论在创伤失血性休克患者的救治中应用骨髓腔穿刺技术建立血管通路,具有快速、有效的特点,同时能够提高抢救成功率。Objective To investigate the effects of clinical application of the establishment of vascular access technique through marrow cavity puncture in the treatment of patients with traumatic hemorrhagic shock.Methods 66 patients with traumatic hemorrhagic shock admitted and treated in our hospital from January 2016 to December 2018 were selected,while 32 patients treated with central venipuncture to establish infusion access from January 2016 to June 2017 were included in the control group,and 34 patients treated with marrow cavity puncture to establish vascular access from July 2017 to December 2018 were included in the IO group.After the infusion access was established in the two groups of patients,the one-time puncture success rate,the time of successful establishment of vascular access,and the time when blood pressure began to rise in the two groups were observed,and the response rate for rescue within 24 h was observed.Results The one-time puncture success rate of patients in the IO group was 100.0%,which was significantly higher than that in the control group(53.1%),the difference was statistically significant(P<0.05);The infusion access establishment time in the IO group was(1.7±0.8)min,which was significantly lower than that in the control group(7.2±2.8 min),the difference was statistically significant(P<0.05);The blood pressure rise time in the IO group was(7.3±2.4)min,which was significantly lower than that in the control group(17.6±4.5)min,the difference was statistically significant(P<0.05);the response rate for rescue within 24 h in the IO group was 91.2%,which was significantly higher than that in the control group(75.0%),the difference was statistically significant(P<0.05).Conclusion In the treatment of patients with traumatic hemorrhagic shock,the application of marrow cavity puncture technique to establish vascular access has the characteristic of being rapid and effective,and can improve the success rate of rescue at the same time.

关 键 词：骨髓腔穿刺 血管通路 创伤 失血性休克 

分 类 号：R459.7[医药卫生—急诊医学]