桡动脉穿刺前手部血液供应的评估方法  

Evaluation method of blood supply to hand before radial artery puncture

作　　者：杨晓亚 崔朝勃(审校)[1] 王金荣[1] YANG Xiaoya;CUI Chaobo;WANG Jinrong

机构地区：[1]哈励逊国际和平医院重症医学科,河北衡水053000

出　　处：《临床急诊杂志》2020年第6期512-516,共5页Journal of Clinical Emergency

摘　　要：重症监护病房(intensive care unit,ICU)的患者病情较重,常需结合血流动力学监测指标指导患者治疗,其中有创血压监测是临床上经常用到的有创监测之一。由于桡动脉表浅,易触及,而尺动脉不易触及,其通畅性不易评估,所以,临床工作中,首选桡动脉穿刺。由于危重患者可能需连续几天监测有创血压,在动脉留置导管针期间,可能出现血肿、出血、血栓形成、动脉暂时闭塞、假性动脉瘤、动静脉瘘、肢体缺血、周围神经病变以及局部或全身感染等并发症。The patients in intensive care unit(ICU)are in serious condition and often need hemodynamic monitoring,invasive blood pressure monitoring is one of the common monitoring methods.The radial artery is the first choice since it is superficial and easily accessible.If the puncture results in thrombosis or vascular occlusion in the radial artery,and the radial and ulnar arteries anastomose poorly,it will lead to the complications such as ischemia and gangrene at the finger end of the puncture hand,and result in serious adverse consequences.Therefore,before the puncture,it is necessary to routinely evaluate the anastomosis between the radial artery and the ulnar artery,evaluate the patient’s hand blood supply,and choose the puncture blood vessel,reasonably to avoid the occurrence of the above-mentioned adverse events.The most commonly used methods are the Allen test and the modified Allen test in clinical work.For patients with serious illness such as confusion,edema,and anemia,color Doppler ultrasound combined with the Allen test can more accurately determine the hand blood of patients.It is worth promoting in clinical work.

关 键 词：重症监护病房 手部血液供应 有创血压 ALLEN试验 彩色多普勒超声 

分 类 号：R614[医药卫生—麻醉学]