重症患者超声引导下腋静脉穿刺与锁骨下静脉穿刺比较的临床研究  

作　　者：李晓勇[1] 李敏[1] 

机构地区：[1]粤北人民医院重症医学科,广东韶关512026

出　　处：《人人健康》2022年第26期81-83,共3页Health for Everyone

摘　　要：目的:探讨通过超声引导进行腋静脉穿刺置入中心静脉导管的安全性及有效性。方法:采用前瞻性随机对照研究(RCT)方法,选择2019年10月至2020年9月粤北人民医院重症医学科(ICU)收治的需要中心静脉置管患者68人。随机分为两组,实验组(n=33)在超声引导下行腋静脉穿刺置管;对照组(n=35)采用常规通过体表标志定位进行锁骨下静脉穿刺置管。记录两组穿刺操作用时,一针穿刺成功率,总穿刺成功率,操作并发症的发生率。结果:实验组操作用时短于对照组(12.4±4.1)分钟与(12.4±4.1)分钟,P<0.05,一针穿刺成功率高于对照组、并发症发生率低于对照组,无统计学意义。结论:超声引导下经腋静脉穿刺置管较传统体表定位法锁骨下静脉置管能有效提高穿刺成功率,缩短操作时间,降低并发症发生率,提高了中心静脉穿刺的安全性,值得在重症医学科临床工作中推广应用。Objective:To investigate the safety and effectiveness of ultrasound-guided axillary venipunction into central venous catheter.Methods:A prospective randomized controlled study(RCT)was used to select 68 patients requiring central venous catheterization admitted to Intensive Care Unit(ICU)of North Guangdong People's Hospital from October 2019 to September 2020.They were randomly divided into two groups.The experimental group(n=33)underwent axillary venipuncture catheterization under ultrasound guidance.In the control group(n=35),subclavian venipuncture was performed by routine location of body surface markers.The puncture operation time,the success rate of one needle puncture,the total success rate of puncture puncture and the incidence of operation complications were recorded in the two groups.Results:The operation time of the experimental group was shorter than that of the control group(12.4±4.1)minutes and(12.4±4.1)minutes,P<0.05.The success rate of one-needle puncture was higher than that of the control group,and the complication rate was lower than that of the control group,without statistical significance.Conclusions:Ultrasound-guided transaxillary vein catheterization can effectively improve the success rate of puncture,shorten the operation time,reduce the incidence of complications,and improve the safety of central vein catheterization compared with the traditional surface positioning method.It is worthy of popularization and application in the clinical work of intensive care medicine.

关 键 词：腋静脉 中心静脉置管 重症超声 

分 类 号：R47[医药卫生—护理学]