不同皮下注射手法针尖到达目标组织的超声显影及比较性研究  

Ultrasonography and comparative study of needle tip reaching the target tissue with different kinds of subcutaneous injection techniques

作　　者：陆胜美[1] 李蓉梅[2] 邱君斓[3] Lu Shengmei;Li Rongmei;Qiu Junlan(Outpatient Injection Room,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Oncology Department,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China;Ultrasound Diagnostic Department,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院门诊注射室,南京210008 [2]南京大学医学院附属鼓楼医院肿瘤科,南京210008 [3]南京大学医学院附属鼓楼医院超声诊断科,南京210008

出　　处：《中国实用护理杂志》2023年第23期1792-1796,共5页Chinese Journal of Practical Nursing

摘　　要：目的在超声显影下比较2种皮下注射手法针尖到达目标组织的准确率,为临床注射做出安全合理的决策提供依据。方法采用平行对照非劣效比较研究,便利选取2021年6月至2022年9月南京大学医学院附属鼓楼医院门诊注射室皮下注射患者68例为研究对象,按照随机数字表法分为A、B 2组各34例。A组为捏起皮肤注射,B组为绷紧皮肤注射,统一注射部位、注射针长度、进针角度。通过超声显影比较2组针尖到达目标组织,即皮下脂肪层的准确率,并观察2组患者的疼痛评分及注射过程中的影像表现。结果针尖到达皮下脂肪层的准确率A组为97.1%(33/34),与B组的100.0%(34/34)比较差异无统计学意义(χ^(2)=0.53,P>0.05)。2组的疼痛评分分布比较差异无统计学意义(χ^(2)=0.67,P>0.05)。不同疼痛评分的患者间年龄、皮下脂肪厚度及针尖到肌筋距离比较,差异均无统计学意义(F=1.20、0.44,H=0.64,均P>0.05)。结论在一定条件下,捏起与绷紧皮肤2种注射手法针尖到达目标组织皮下脂肪层的准确率、安全性一致,应根据临床实境进行选择。影像学观察对皮下注射操作实践具有启示意义。Objective To compare the accuracy of the needle tip reaching the target tissue between two subcutaneous injection techniques under ultrasound imaging in order to provide a basis for clinical injection to make a safe and reasonable decision.Methods This was a parallel controlled non-inferiority comparative study.A total of 68 patients who received subcutaneous injections in the outpatient injection room of Nanjing Drum Tower Hospital Affiliated to Nanjing University from June 2021 to September 2022 were selected as the research subjects,and they were divided intothe A and B group according to the random number table method,there were 34 cases in each group.Group A received pinched skin injections,and group B received taut skin injections.Unify the injection site,injection needle length,and needle insertion angle.The accuracy rate of the needle tip reaching the target tissue,namely the subcutaneous fat layer,was compared between the two groups by ultrasound imaging,and the pain scores and the imaging performance during the injection process were observed.Results The accuracy of the needle tip reaching the subcutaneous fat layer in the group A was 97.1%(33/34),which compared with the 100.0%(34/34)in the group B,there was no significant difference(χ^(2)=0.53,P>0.05).There was no significant difference about the distribution of pain scores between the two groups(χ^(2)=0.67,P>0.05).There were no significant differences about age,subcutaneous fat thickness and the distance from the needle tip to the myofascial in patients with different pain scores(F=1.20,0.44,H=0.64,all P>0.05).Conclusions Under certain conditions,pinching the skin and tightening the skin have the same accuracy and safety when the needle tip reaches the subcutaneous fat layer of the target tissue,and the choice should be made according to the clinical situation.Imaging observations have enlightening significance for the practice of subcutaneous injection.

关 键 词：皮下注射 方法 超声波 皮下组织 

分 类 号：R472[医药卫生—护理学]