早产儿桡动脉采血不同进针角度对血气分析标本的影响  

Effect of Two Different Angles of Puncture in Premature Radial Arterial Blood Gas Sampling

作　　者：黄莹莹 梁焕瑛 张泸尹 姜喜 庞永通 HUANG Ying-ying;LIANG Huan-ying;ZHANG Lu-yin;JIANG Xi;PANG Yong-tong(Neonate Department of Guangxi Pubei People's Hospital,Pubei County,Guangxi Zhuang Autonomous Region,535399,China)

机构地区：[1]广西浦北县人民医院新生儿科,广西浦北535399

出　　处：《蛇志》2021年第4期448-449,472,共3页Journal of Snake

基　　金：2017年广西壮族自治区卫生和计划生育委员会立项计划课题(项目名称:提高早产儿桡动脉采血穿刺成功率角度的探讨,项目编号:Z20171008)。

摘　　要：目的探讨早产儿桡动脉采血不同进针角度对血气分析标本合格率的影响。方法采用连续抽样方法选取我院新生儿科住院早产儿经桡动脉采集血气分析标本,其中以2019年9~11月的67份血气分析标本为对照组,2020年1~3月采集的60份血气分析标本为观察组,两组患儿均由桡动脉采血规范化培训考核合格的护士统一对患儿取同样体位采用十字定位法,均使用5.5号头皮针连接抽取10 U/ml肝素钠盐水0.5 ml进行充分浸润的1 ml注射器行斜刺法采血。对照组采用40°角进针,观察组采用10~20°角进针,观察两组标本的合格率。结果对照组67份标本中,3份有气泡,10份血标本凝集,15份一次穿刺采血量不足0.5 ml,合格标本39份,合格率58.21%;观察组60份标本中,1份有气泡,3份血标本凝集,4份一次穿刺采血量不足0.5 ml,合格标本52份,合格率86.67%。两组的标本合格率比较差异有统计学意义(P<0.05)。结论采用10~20°角进针行桡动脉采血能有效提高早产儿血气分析标本合格率,有助于保障血气分析结果的准确性。Objective To explore the effect of different puncture angles on the qualified rate in premature radial arterial blood gas sampling.Methods Successive sampling method was adopted to collect blood gas samples from premature infants who received radial arterial blood gas sampling.A total of 67 specimens collected from September to November in 2019 were chosen as the control group,while 60 specimens from January to March in 2020 were chosen as the observation group.Both groups got needle insertion in the same position with a No.5.5 scalp needle attached to a 1 ml syringe of 0.5 ml heparin sodium saline solution at a concentration of 10 U/ml.Methods of cross positioning and oblique insertion were performed by the nurses,who were qualified in standardized training for the examination of radial artery blood sampling training.In the control group,the needle was inserted obliquely to form on angle of approximately 40 degrees with the skin,while the angles in the observation group were about 10 to 20 degrees.Finally,the specimen qualified rate was observed.Results In the control group,39 specimens were qualified with the pass rate of 58.21%,and there were 3 specimens with air bubbles,10 with blood agglutination reaction and 15 with inadequate blood below 0.5 ml in one-time insertion.In the observation group,52 specimens were qualified with a pass rate of 86.67%,and there were 1 specimen with air bubbles,3 with blood agglutination reaction and 4 with inadequate blood below 0.5 ml in one-time insertion.By comparing the above indexes between the two groups,the difference was statistically significant(P<0.05).Conclusion In the premature radial arterial blood sampling,oblique insertion with an angle of 10 to 20 degree can effectively increase the qualified rate of blood gas sampling,ensure accuracy of blood gas findings and provide the research basis for clinical treatment of critical premature infants.

关 键 词：早产儿 桡动脉 采血 进针角度 血气分析标本 

分 类 号：R722[医药卫生—儿科] R473.72[医药卫生—临床医学]