超声引导腋静脉穿刺置管术在急诊危重症中的应用体会  

Application of ultrasound-guided axillary venipuncture and catheterization in emergency critical patients

作　　者：王霆[1] 奚培培 张霞[1] WANG Ting;XI Peipei;ZHANG Xia(Department of Emergency Medicine,the Affiliated Hospital of Nantong University,Nantong,Jiangsu,226001,China)

机构地区：[1]南通大学附属医院急诊医学科,江苏南通226001

出　　处：《临床急诊杂志》2021年第9期627-630,共4页Journal of Clinical Emergency

摘　　要：目的:探索超声引导腋静脉穿刺置管术应用于急诊危重症的可行性和安全性并比较左右两侧腋静脉径路的异同。方法:进行前瞻性研究,以急诊重症监护室(EICU)收治并行超声引导腋静脉穿刺置管术者为研究对象,详细记录临床资料和穿刺置管资料。共56例患者纳入研究,按穿刺置管部位分为左侧腋静脉组(L组)和右侧腋静脉组(R组),对两组患者的数据进行统计学分析。结果:L组穿刺置管成功率(20/21,95.2%)和R组(35/35,100.0%)相比,差异无统计学意义(P>0.05)。L组并发症发生率(0/21,0.0%)和R组(1/35,2.9%)相比,差异无统计学意义(P>0.05)。L组和R组的解剖定位与超声定位相符的比例分别为66.7%和77.1%,差异无统计学意义(P>0.05)。L组导管内置长度[(18.76±1.45)cm]大于R组[(14.97±1.56)cm],差异有统计学意义(P<0.05)。L组导管头端到达恰当位置比例(17/20,85.0%)和R组(31/35,88.6%)相比,差异无统计学意义(P>0.05)。结论:超声引导腋静脉穿刺置管术成功率高、安全性好,两侧腋静脉穿刺置管均适用于急诊危重症的抢救。Objective:To explore the feasibility and safety of ultrasound-guided axillary vein puncture and catheterization in critical patients of emergency department and to compare the similarities and differences between through left axillary veinand through right axillary vein.Methods:A prospective study was conducted on patients undergoing ultrasound-guided axillary venipuncture and catheterization in the emergency intensive care unit(EICU).The clinical data and catheterization data were recorded in detail.A total of 56 patients were included in the study.They were divided into left axillary vein group(L group)and right axillary vein group(R group)according to the location of puncture and catheterization,and the data of the two groups were statistically analyzed.Results:There was no significant difference in the success rate of puncture between the L group(20/21,95.2%)and the R group(35/35,100%)(P>0.05).There was no significant difference in the incidence of complications between the L group(0/21,0.0%)and the R group(1/35,2.9%)(P>0.05).The proportion of anatomical location consistent with ultrasonic location in L group and R group was 66.7%and 77.1%,respectively,and the difference was not statistically significant(P>0.05).The catheter length in the L group[(18.76±1.45)cm]was greater than that in the R group[(14.97±1.56)cm],and the difference was statistically significant(P<0.05).There was no significant difference in the proportion of catheter tip reaching the proper position between group L(17/20,85.0%)and group R(31/35,88.6%)(P>0.05).Conclusion:Ultrasound-guided axillary venipuncture and catheterization have high success rate and good safety.Both sides of axillary venipuncture and catheterization are suitable for emergency rescue of critical patients.

关 键 词：超声引导 腋静脉穿刺 急诊重症监护室 

分 类 号：R459.7[医药卫生—急诊医学]