不同时机局麻对超声引导下PICC置管术引起的疼痛和穿刺次数的影响  

Effect of the local anesthesia in different time on the pain caused by ultrasound-guided PICC catheterization and puncture times

作　　者：白茹[1] 陈永侠[1] 王莉[1] 张静 BAI Ru;CHEN Yong-xia;WANG Li;ZHANG Jing(Department of Surgical Oncology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004;School of Nursing,Bengbu Medical College,Bengbu Anhui 233030,China)

机构地区：[1]蚌埠医学院第一附属医院肿瘤外科,安徽蚌埠233004 [2]蚌埠医学院护理学院,安徽蚌埠233030

出　　处：《蚌埠医学院学报》2021年第6期826-829,共4页Journal of Bengbu Medical College

基　　金：安徽省高校自然科学研究项目(KJ2017A214);蚌埠医学院自然科学研究面上项目(BYKY1689)。

摘　　要：目的:对不同时机局麻后PICC置管所致疼痛和穿刺次数进行比较。方法:选择2018-2019年在蚌埠市某三甲医院进行PICC置管的病人90例,按照随机数字法分为对照组(穿刺后麻醉)和观察组(穿刺前麻醉),每组各45例。评估2组穿刺对病人疼痛及穿刺次数的影响。结果:观察组与对照组局部疼痛程度评分差异无统计学意义(P>0.05)。观察组穿刺次数多于对照组(P<0.05)。观察组局麻前血管直径大于局麻后(P<0.05),局麻前后血管距皮的距离变化无统计学意义(P>0.05)。结论:在行超声引导下改良塞丁格技术PICC置管时,穿刺前麻醉与穿刺后麻醉对于病人的疼痛无影响,但穿刺前麻醉会导致血管收缩,增加穿刺难度。Objective:To compare the pain caused by peripherally inserted central catheter(PICC)catheterization and number of punctures after local anesthesia at different time.Methods:From^(2)018 to 2019,90 patients treated with PICC catheterization at a grade A tertiary hospital in Bengbu city were randomly divided into the control group(post-puncture anesthesia)and observation group(pre-puncture anesthesia)(45 cases in each group).The effects of puncture on patients′pain and number of puncture were evaluated in two groups.Results:There was no statistical significance in local pain scores between two groups(P>0.05).The number of puncture in observation group was more than that in control group(P<0.05).The diameter of blood vessels before local anesthesia in observation group was larger than that after local anesthesia(P<0.05),and there was no statistical significance in the distance from blood vessels to skin between before and after local anesthesia(P>0.05).Conclusions:The PICC catheterization with modified seldinger technique guided by ultrasound is performed,the pre-puncture anesthesia and post-puncture anesthesia had no effect on the patient′s pain,but the pre-puncture anesthesia can lead to the vasoconstriction and increase the difficulty of puncture.

关 键 词：经外周静脉置入中心静脉导管置管术 超声引导 局麻 疼痛 

分 类 号：R473.73[医药卫生—护理学]