便携式超声引导下中心静脉置管在神经内科重症患者中的应用(附罕见并发症一例报道)  

Application Value of Portable Ultrasound-guided Central Venous Catheterization in Neurological Intensive Patients(a Case Report of its Rare Complication Attached)

作　　者：周栎[1] 彭熠[1] ZHOU Li;PENG Yi(Department of Neurology,People’s Hospital of Hunan Province,Changsha 100009,China)

机构地区：[1]湖南省人民医院(湖南省师范大学第一附属医院)神经内科,湖南长沙410000

出　　处：《医学临床研究》2021年第7期1031-1034,共4页Journal of Clinical Research

摘　　要：[目的]探讨便携式超声引导下中心静脉置管术(Central Venous Catheterization,CVC)的临床效果及.安全性。[方法]回顾性分析2019年6月至2020年6月在本院神经内科行CVC患者125例。其中56例作为观察组,是在便携式超声引导下行CVC;另外69例作为对照组,采用传统体表标志定位下行CVC。观察两组一次穿刺成功率、并发症发生率及穿刺时间,并对其并发症深入分析。[结果]观察组一次穿刺成功率显著高于对照组[92.9%(52/56)vs 72.5%(50/69)],而并发症发生率显著低于对照组[0%(0/56)vs 11.6%(8/69)].穿刺时间显著短于对照组[(8.31±1.41)min vs(11.72±1.52)min],差异均有统计学意义(P<0.05)。对照组1例患者因导丝误入横突孔,导致导丝嵌顿,无法拔出,后通过外科手术取出导丝。[结论]便携式超声引导下行CVC可以显著提高一次穿刺成功率、缩短穿刺时间、降低其并发症发生率,值得临床推广应用。[Objective]To explore the effect and safety of portable ultrasound guided central venous catheterization.[Methods]A total of 125 cases of central venous catheterization in our department were collected,56 of which were used as the observation group,which was catheterized under portable ultrasound guidance,and the other 69 cases were used as the control group using traditional body surface markers to locate.Puncture success rate,complication rate,and puncture time were compared between the two groups.[Results]The success rate of one puncture in the observation group was significantly higher than that in the control group[92.9%(52/56)vs 72.5%(50/69),P<0.05],the complication rate in the observation group was lower than that in the control group[0%(0/56)vs 11.6%(8/69),P<0.05],and the puncture time in the observation group was shorter than that in.the control group[(8.31±1.41)min vs.(11.72±1.52)min,P<0.05].A patient in the control group caused the guide wire to be incarcerated and could not be pulled out because the guide wire was mistakenly inserted into the transverse hole.After that,the guide wire was removed by surgery.[Conclusion]Portable ultrasound can significantly improve the success rate of one time puncture,shorten the puncture time,reduce the incidence of complications,and provide convenience for clinical treatment,which is worthy of wide promotion.

关 键 词：导管 留置 导管插入术 中心静脉/方法 超声检查 危重病人医疗 

分 类 号：R47[医药卫生—护理学]