实时超声三步法引导患者颈内静脉穿刺置管建立临时血管通路的效果  

Effect of real-time ultrasound three-step method guiding patients to establish temporary vascular access through internal jugular vein puncture and catheterization

作　　者：湛永健 何同林 湛雪群 湛淑怡 叶楚莉 ZHAN Yongjian;HE Tonglin;ZHAN Xuequn;ZHAN Shuyi;YE Chuli(Department of Ultrasound Examination,Zengcheng Xintang Hospital,Guangdong Province,Guangzhou 511340,China)

机构地区：[1]广州市增城区新塘医院超声检查科,广东广州511340

出　　处：《中国当代医药》2024年第35期88-91,共4页China Modern Medicine

基　　金：广东省广州市卫生健康科技两新项目(20241A040019)。

摘　　要：目的研究实时超声三步法引导患者颈内静脉(IJV)穿刺置管建立临时血管通路的效果。方法选取2023年4月至2024年4月于广州市增城区新塘医院需建立临时血管通路的60例慢性肾脏病(CKD)5期患者作为研究对象,按照随机数字表法分为观察组和对照组,每组各30例。对照组采用盲探法IJV穿刺置管,观察组采用实时超声三步法引导IJV穿刺置管。比较两组IJV穿刺置管一次成功率、置管使用时间、住院总费用、并发症及满意度。结果观察组IJV穿刺置管一次成功率高于对照组,置管使用时间长于对照组,住院总费用及并发症总发生率低于对照组,总满意度高于对照组,差异有统计学意义(P<0.05)。结论实时超声三步法引导IJV穿刺置管建立临时血管通路的一次成功率高于盲探法IJV穿刺置管,可延长置管使用时间,降低并发症及住院总费用,患者满意度相对更高。Objective To investigate the effect of real-time ultrasound three-step guidance on establishing temporary vascular access through internal jugular vein(IJV)puncture and catheterization in patients.Methods A total of 60 patients with stage 5 chronic kidney disease(CKD)who needed to establish temporary vascular access at Zengcheng Xintang Hospital from April 2023 to April 2024 were selected as the study objects,and they were divided into observation group and control group according to random number table method,with 30 patients in each group.The control group used blind probing method for IJV puncture and catheterization,while the observation group used real-time ultrasound three-step method to guide IJV puncture and catheterization.The success rate of IJV puncture and catheterization at one time,time of catheterization,total hospitalization cost,complications and satisfaction were compared between the two groups.Results The success rate of IJV puncture and catheterization at one time in the observation group was higher than that in the control group,the use time of catheterization was longer than that in the control group,the total hospitalization cost and the total complication rate were lower than those in the control group,and the total satisfaction was higher than those in the control group,with statistical significances(P<0.05).Conclusion The success rate of real-time ultrasound three-step method to guide IJV puncture and catheterization at one time for establishing temporary vascular access is higher than that of blind probing method for IJV puncture and catheterization,which can prolong the use time of catheterization,reduce complications and total hospitalization costs,and relatively increase patient satisfaction.

关 键 词：终末期肾病 实时超声三步法 血液透析 颈内静脉穿刺置管 穿刺置管成功率 并发症 

分 类 号：R692[医药卫生—泌尿科学]