三种危重患者外周静脉置管技术的效果对比  

Comparison of Three Techniques of Peripheral Venous Catheterization in Critically Ill Patients

作　　者：潘静[1,3] 刘光娣 刘逸文[2,3] 唐荔 PAN Jing;LIU Guangdi;LIU Yiwen;TANG Li(Department of Respiratory and Critical Care Medicine,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China;Department of Critical Care Medicine,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China;West China School of Nursing,Sichuan University,Chengdu Sichuan 610041,China)

机构地区：[1]四川大学华西医院呼吸与危重症医学科,四川成都610041 [2]四川大学华西医院重症医学科,四川成都610041 [3]四川大学华西护理学院,四川成都610041

出　　处：《中国医疗设备》2022年第7期139-143,共5页China Medical Devices

基　　金：四川省科技厅重点研发项目(2019YFS0292)。

摘　　要：目的通过比较三种穿刺技术在危重患者外周静脉置管中应用的效果,为选择最佳的穿刺路径提供依据。方法将呼吸与危重症医学科2021年7—12月收治的需要进行外周静脉置管的90例患者,按照不同的穿刺方式分为三组(传统组30例、超声组30例、近红外组30例),比较三组技术操作耗时(含刺入目标血管耗时、总穿刺耗时)、穿刺频次、首次穿刺成功率、导管留置时间以及置管相关并发症的发生率。结果近红外组的总穿刺耗时(182.80±32.17)s显著低于传统组(437.57±158.96)s和超声(330.87±77.34)s(P<0.001),且超声组耗时又显著低于传统组;超声组和近红外组在穿刺频次、首次穿刺成功率、以及导管留置时间方面均优于传统组(P=0.038、0.044、0.001)。传统组的并发症总发生率显著高于超声组和近红外组(P=0.024)。虽然三组的感染发生率无明显差异,但超声组和近红外组的水肿发生率以及局部出血发生率显著低于传统组(P=0.046、0.032)。结论利用血管可视化技术引导危重患者外周静脉置管相较于传统静脉穿刺技术,可以明显提高穿刺成功率,减少操作时间和置管并发症的发生,并能够显著延长外周静脉导管有效留置时间。对于血管深度>6 mm的患者,更适合采用超声引导下的穿刺置管。Objective To provide the basis for selecting the best puncture path by comparing the effects of three puncture techniques in peripheral venous catheterization of critically ill patients.Methods A total of 90 patients requiring peripheral venous catheterization admitted to the department of respiratory and critical care medicine from July to December 2021 were divided into three groups according to different puncture methods(30 patients in the traditional group,30 patients in the ultrasound group,and 30 patients in the near infrared group).The technical operation time(including the time of puncture into the target blood vessel and the total puncture time),puncture frequency,first puncture success rate,catheter indwelling time and the incidence of catheter-related complications were compared among the three groups.Results The total puncture time of the near infrared group which was(182.80±32.17)s was significantly lower than that of the traditional group and the ultrasound group which were(437.57±158.96)s and(330.87±77.34)s respectively(P<0.001),and the ultrasound group was significantly lower than that of traditional group.The ultrasound group and the near-infrared group were better than the traditional group in puncture frequency,first puncture success rate,and catheter indwelling time(P=0.038,0.044,0.001).The total incidence of complications of the traditional group was significantly higher than that of the ultrasound group and the near infrared group(P=0.024).Although there was no significant difference in the incidence of infection among the three groups,the incidence of edema and local bleeding in the ultrasound group and the near infrared group were significantly lower than those in the traditional group(P=0.046,0.032).Conclusion Compared with traditional venipuncture technique,peripheral venous catheterization guided by vascular visualization technology can significantly improve the puncture success rate,reduce the operation time and catheterization complications,and significantly prolong the effective i

关 键 词：血管可视化技术 超声引导穿刺 近红外可视化技术引导穿刺 外周静脉置管 

分 类 号：R472.9[医药卫生—护理学]