超声引导动态针尖定位法与传统触诊法桡动脉穿刺成功率比较  

作　　者：陈悦[1] 吴佳[1] 王瑜[1] 刘惠子 楼小侃[1] 

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院),310014

出　　处：《浙江临床医学》2022年第7期1030-1032,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划面上项目(2020KY450,2022KY504)。

摘　　要：目的探讨超声引导下动态针尖定位法与传统触诊法桡动脉穿刺置管成功率比较.方法选择需要桡动脉穿刺置管的手术患者60例,随机分为对照组(传统触诊法)和观察组(超声引导动态针尖定位法)2组,每组30例.10名规范化培训的急诊科或ICU住院医师行桡动脉穿刺置管.记录总穿刺次数、桡动脉穿刺第一次成功率和总穿刺成功率、穿刺时间、并发症包括血肿、血管痉挛等.结果两组间患者术前桡动脉直径和桡动脉横截面积的比较差异无统计学意义(P>0.05);两组间操作医师在性别、年龄、学历构成、培训前工作年限等方面的比较差异无统计学意义(P>0.05).与传统触诊法相比,超声引导动态针尖定位法桡动脉穿刺置管的总穿刺次数显著减少(2.3±0.8 VS. 1.8±0.9,P=0.018),穿刺第一次成功率(50.0% VS. 20.0%,P=0.029)和总穿刺成功率显著增高(76.7% VS. 40.0%,P=0.009),穿刺时间明显缩短(387.4±177.1 VS. 283.4±133.2,P=0.013).两组间桡动脉穿刺并发症差异无统计学意义.结论本研究建议急诊科或ICU住院医师行桡动脉穿刺置管时采用超声引导下的动态针尖定位法,相比传统触诊法,其可减少桡动脉穿刺次数,提高穿刺成功率和缩短穿刺时间.Objectives To explore the comparison of the success rate of radial arterial cannulation between ultrasound-guided dynamic needle tip positioning technique and traditional palpation technique.Methods We enrolled 60 patients who were having surgical treatment that required a radial arterial catheter for intraoperative monitoring in our center.Patients were randomized to either control group(traditional palpation technique)or observation group(ultrasound-guided dynamic needle tip positioning technique),with 30 in each group.Arterial cannulation was performed by 10 emergency or ICU residents in standardized training.The total number of puncture,successful cannulation on the first pass,overall success rate,total puncture time and complications including hematoma and vasospasm were recorded.Results There was no significant difference in radial artery diameter and radial artery cross-sectional area during preoperative period between the two groups(P>0.05).There was no significant difference between the two groups in terms of gender,age,educational composition,and working years before training(P>0.05).Compared with the traditional palpation technique,the total numbers of puncture of radial arterial cannulation with dynamic needle tip positioning technique were significantly reduced(2.3±0.8 VS.1.8±0.9,P=0.018).First-pass success rate(50.0%VS.20.0%,P=0.029)and overall success rate(76.7%VS.40.0%,P=0.009)was significantly higher,and total puncture time was significantly shortened(387.4±177.1 VS.283.4±133.2,P=0.013).No significant difference was observed in radial arterial cannulation complications between the two groups.Conclusion In this study,it is recommended that emergency or ICU residents use ultrasound-guided dynamic needle tip positioning technique when performing radial arterial cannulation,for its reduced number of puncture,higher success rate and shortened puncture time compared with the traditional palpation technique.

关 键 词：超声引导 动态针尖定位法 触诊法 桡动脉穿刺置管 住院医师 

分 类 号：R459.7[医药卫生—急诊医学]