B超引导下经胸壁段腋静脉置管改良法在急诊颅脑手术患者中的临床研究  

Clinical study on the improved method of transthoracic axillary vein catheterization under B-ultrasound guidance in emergency craniocerebral surgery patients

作　　者：蔡青 邱俊毅 蓝聪 CAI Qing;QIU Junyi;LAN Cong(The First People's Hospital of Nankang District,Ganzhou 341400,China)

机构地区：[1]赣州市南康区第一人民医院,江西赣州341400

出　　处：《临床医药实践》2024年第12期885-888,共4页Proceeding of Clinical Medicine

基　　金：赣州市科技计划项目(项目编号:GZ2023ZSF491)。

摘　　要：目的:探讨B超引导下经胸壁段腋静脉置管改良法在急诊颅脑手术患者中的临床应用效果。方法:选择2022年5月—2023年5月于赣州市南康区第一人民医院实施急诊颅脑手术的164例患者作为研究对象,按随机数字表法分为对照组和观察组,每组82例。对照组采用B超引导下颈内静脉置管,观察组采用B超引导下经胸壁段腋静脉改良法置管,比较两组患者相关手术指标、相关穿刺指标、并发症发生情况。结果:两组穿刺时间和导管留置时间比较,差异无统计学意义(P>0.05)。两组一次穿刺成功率、一次以上穿刺成功率以及总穿刺成功率比较,差异无统计学意义(P>0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05);观察组护理难度评分低于对照组,差异有统计学意义(P<0.05)。结论:急诊颅脑手术患者采用B超引导下经胸壁段腋静脉置管改良法的静脉置管穿刺成功率与颈内静脉穿刺相当,但前者可以降低并发症发生率和术后护理难度。Objective:To explore the clinical application value of the improved method of transthoracic axillary vein catheterization guided by B-ultrasound in emergency craniocerebral surgery patients.Methods:All 164 patients who underwent emergency craniocerebral surgery at the first people's hospital of nankang district,ganzhou city,from May 2022 to May 2023,were selected as study subjects and randomly divided into a control group and an observation group,with 82 patients in each group,using a random number table method.The control group used B-ultrasound guided internal jugular vein catheterization,while the observation group used B-ultrasound guided modified axillary vein catheterization through the chest wall segment.The relevant surgical indicators,puncture indicators,and complications of the two groups of patients were compared.Results:There was no significant difference in puncture time and indwelling time between two groups(P>0.05).There was no statistically significant difference in the success rates of single puncture,more than one puncture,and total puncture between the two groups(P>0.05).The incidence of complications in the observation group was lower than that in the control group,with a statistical significant difference(P<0.05).The nursing difficulty score of the observation group was lower than that of the control group,with a statistical significant difference(P<0.05).Conclusion:The success rate of venous catheterization using the improved method of axillary vein through chest wall segment guided by ultrasound in emergency craniocerebral surgery patients is comparable to that of internal jugular vein catheterization.However,the former can reduce the incidence of complications and postoperative nursing difficulties,and has certain application value in emergency craniocerebral surgery patients.

关 键 词：B超引导 经胸壁段腋静脉 静脉置管 

分 类 号：R47[医药卫生—护理学]