B超实时引导血管穿刺置管在婴幼儿先心病手术中的应用  

Application of B-ultrasound Real-time Guided Arteriovenous Puncture in Surgical Treatment of Congenital Heart Disease in Infants

作　　者：陈晓凤[1] 李志坚[1] 戴茹萍[1] 徐军美 CHEN Xiao-feng;LI Zhi-jian;DAI Ru-ping(Department of Anesthesia,The Second Xiangya Hospital of Central South University,Changsha,410011,Hunan,China)

机构地区：[1]中南大学湘雅二医院麻醉科,湖南长沙410011

出　　处：《医学临床研究》2021年第11期1628-1631,共4页Journal of Clinical Research

摘　　要：【目的】评价B超实时引导血管穿刺置管在婴幼儿先天性心脏病(先心病)手术中的临床应用效果。【方法】先心病择期手术需行动静脉穿刺置管术的患儿70例,男36例,女34例,年龄0〜1岁,ASA分级Ⅱ〜Ⅲ级,按随机数字表法分为超声组和传统组,每组35例。超声组使用超声实时定位血管,并用短轴平面外法进行穿刺置管;传统组使用传统解剖定位法定位血管进行穿刺置管。【结果】超声组总穿刺时间、总穿刺次数、使用穿刺针数量及出现并发症例数均少于传统组,其差异均有显著性意义(P<0.05)。【结论】B超实时引导血管穿刺置管应用于婴幼儿先心病手术,相对于传统盲穿手法具有穿刺时间少、成功率高、并发症少的优点,值得临床推广应用。【Objective】To evaluate the clinical effect of B-ultrasound real-time guided arteriovenous puncture in surgical treatment of congenital heart disease in infants.【Methods】In this research,70 cases of infants with congenital heart disease to receive catheterization for arteriovenous puncture with elective surgery are selected,including 36 boys and 34 girls aged 0~1,ASA classification Ⅱ〜Ⅲ.Cases are divided by random number table into an ultrosound group and an anatomical group,each of 35 patients:the ultrasound group with ultrasonic short axis/out-of-plane location of radial artery and jugular vein;the anatomical group,using the traditional anatomical positioning method to locate radial artery and jug-ular vein for catheterization.【Results】Radial artery puncture:the ultrasound group showed shorter total puncture time,fewer total puncture times and vsmaller number of puncture needles used than the anatomical group;the anatomical group showed more cases of arterial hematoma,hemorrhage and other complications than the ultrasound group;all the above differences were statistically significant.Internal jugular vein puncture:the overall success rate and first-time success rate of internal jugular vein catheterization on the right side of infants in the ultrasound group were higher than those of the anatomical group,with puncture time longer than the anatomical group but needle insertion times and puncturing points fewer than the anatomical group.The incidence of mis-operation into arteries in the ultrasound group was significantly lower than the anatomical group.All the above differences were statistically significant.【Conclusion】Compared with the tradi-tional blind catheterization method,B-ultrasound guided arteriovenous puncture in surgical treatment of congenital heart disease in infants shows higher success rate and fewer complications and saves more time for rescue.Therefore,it is worth widespread application in clinical practice.

关 键 词：心脏缺损 先天性/外科学 心脏外科手术 超声检查 穿刺术/方法 导管 留置 

分 类 号：R726.541[医药卫生—儿科]