超声下定位与评估在高龄患者腰椎硬膜外穿刺中的临床应用  

Clinical application of positioning and evaluation under ultrasound in elderly patients undergoing lumbar epidural puncture

作　　者：谢凯[1] 钱俊[1] 陆云梅[1] XIE Kai;QIAN Jun;LU Yunmei(Department of Anesthesiology,Changzhou Wujin Hospital of Traditional Chinese Medicine,Changzhou 213000,China)

机构地区：[1]常州市武进中医医院麻醉科,江苏常州213000

出　　处：《麻醉安全与质控》2021年第6期333-336,共4页Perioperative Safety and Quality Assurance

基　　金：常州市武进区科技计划项目(WS201932)。

摘　　要：目的探讨超声下定位与评估在高龄患者腰椎硬膜外穿刺中的临床应用价值。方法选取2019-08/2020-09期间我院收治的60例拟行腰椎硬膜外穿刺高龄患者,以随机数字表法分为对照组(n=30)及观察组(n=30),对照组行传统体表标志定位法,观察组行超声下定位,对2组穿刺结果进行比较。结果观察组定位时间、穿刺时间、总操作时间均较对照组短(P<0.05);观察组穿刺次数、进针深度、调整穿刺针方向次数与对照组有统计学意义(P<0.05);观察组一次性穿刺成功率为96.67%(29/30),明显较对照组高80.00%(24/30)(P<0.05);观察组穿刺后72 h头痛、腰痛、神经损伤或感觉异常等并发症发生率为3.33%,较对照组20.00%明显降低(P<0.05)。结论超声下定位与评估在高龄患者腰椎硬膜外穿刺中应用价值较高,可缩短定位及穿刺时间,减少穿刺次数,还可减少穿刺后并发症发生,值得应用及推广。Objective To explore the application value of positioning and evaluation under ultrasound in elderly patients undergoing lumbar epidural puncture.Methods From August 2019 to September 2020,60 elderly patients who were scheduled to undergo lumbar epidural puncture were selected and divided into observational group(n=30)and control group(n=30)according to random number table method.The control group underwent traditional body surface marker positioning method,and the observational group underwent ultrasound positioning.The puncture results of the two groups were compared.Results The positioning time,puncture time,and total operation time of the observational group were shorter than those of the control group(P<0.05);meanwhile puncture times,needle insertion depth,and puncture needle direction adjustment times of the observational group were significantly different from those in the control group(P<0.05);the one-time puncture success rate of the observational group was 96.67%(29/30),which was significantly higher than that of the control group 80.00%(24/30)(P<0.05);the incidence of complications such as headache,low back pain,nerve injury or paresthesia 72 h after puncture in the observational group was 3.33%,which was significantly lower than 20.00% in the control group(P<0.05).Conclusion Ultrasound positioning and evaluation is of high value in the treatment of elderly patients undergoing lumbar epidural puncture.It can shorten the positioning and puncture time,reduce the number of punctures,and also reduce the occurrence of complications after puncture.It is worthy of application and promotion.

关 键 词：超声下定位 高龄患者 腰椎硬膜外穿刺 

分 类 号：R614[医药卫生—麻醉学]