"双止血带"结扎上肢穿刺部位对提高手背静脉穿刺成功率的影响  

The effect of"double tourniquet"ligation of upper limb puncture site on improving the success rate of dorsal vein puncture

作　　者：范一明 丁晨莉 Fan Yiming;Ding Chenli(Shanghai University of Traditional Chinese Medicine Affiliated Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai 201801,China)

机构地区：[1]上海中医药大学附属市中医医院,上海201801

出　　处：《首都食品与医药》2024年第17期134-137,共4页Capital Food Medicine

摘　　要：目的 利用"双止血带"结扎上肢穿刺部位,评估穿刺成功率.方法 纳入上海中医药大学附属市中医医院收治的100名幼儿、危重患儿及穿刺困难的患儿进行分析,按照随机数字表法均分成两组,对照组患儿仅进行一般的穿刺结扎措施,观察组利用"双止血带"结扎上肢前臂段穿刺部位为幼儿及危重患儿、静脉充盈度差及难以进行静脉穿刺的患儿进行手背静脉穿刺,以提高静脉穿刺成功率.在肘部和腕关节内关各扎一根止血带,结扎点相距15cm,捆扎1min后,松开下面一根止血带,这时该部位可看到靛色的静脉,这样有利于穿刺并提高静脉穿刺的成功率,止血带的结扣点应在血管旁1-2cm为宜.扎止血带时间不宜过长,过长易造成局部组织缺血缺氧,皮肤发绀,血管走行不明显或把血管压瘪.结果 对照组和观察组的婴幼儿静脉穿刺一针成功率分别为90.00%(45/50)和96.00%(48/50).对照组患儿的SAS评分为(53.27±12.53)分,观察组是(47.22±13.02)分;对照组的SDS分数是(55.31±11.09)分,观察组的SDS分数是(48.46±12.52)分.对照组患儿的功能状态的分数是(90.11±10.21)分,观察组是(98.43±11.67)分(P=0.011).对照组和观察组获得血液检查结果的时间分别为(20.23±12.86)分钟、(12.62±10.37)分钟.对照组和观察组患儿家属的知识掌握程度分别为86.00%(43/50)和96.00%(48/50).对照组和观察组护理质量主观评分总分分别为(82.16±10.33)分和(92.15±12.65)分.结论 利用"双止血带"结扎上肢穿刺部位可以提高穿刺成功率,有很好的临床应用前景.Objective To evaluate the puncture success rate by ligating the puncture site of upper extremity with"Double tourniquet"Methods A total of 100 children,critically ill children and patients with difficulty were included in the study.They were randomly divided into two groups,50 patients in each group,the patients in the control group were only performed general puncture and ligation,in the observation group,the puncture sites of the forearm segment of the upper limb ligated with double"Tourniquet"were children and critically ill children,patients with poor vein flling and those who were difficult to perform venipuncture were performed venipuncture on the dorsum of hand,to improve the success rate of venipuncture.Place a tourniquet on each elbow and wrist joint.The upper and lower parts of the tourniquet were separated 15cm from each other until the vein was flled.After ligating for I min,release the lower tourniquet.At this time,the indigo vein can be seen in this area,the knot point of tourniquet should be opened 1-2cm near the blood vessel.Tie Tourniquet time should not be too long,too long easy to become local tissue ischemia and hypoxia,skin cyanosis,vascular walk is not obvious or vascular pressure deflated.Results The success rate of one needle in control group and observation group were 90.00%(45/50)and 96.00%(48/50)respectively.The SAS scores of the control group and the observation group were(53.27±12.53)and(47.22±13.02)respectively,while the SDS scores of the control group and the observation group were(55.31±11.09)and(48.46±12.52)respectively.The scores of functional status were(90.11±10.21)in the control group and(98.43±11.67)in the observation group(P=0.011).The time of blood examination was(20.23±12.86)minutes in control group and(12.62±10.37)minutes in observation group.The control group and the observation group were 86.00%(43/50)and 96.00%(48/50)respectively.The total scores of subjective nursing quality in control group and observation group were(82.16±10.33)and(92.15±12.65)respectively

关 键 词：双止血带 结扎上肢穿刺部位 手背静脉穿刺成功率 

分 类 号：R472[医药卫生—护理学]