摘要
目的:比较超声平面内引导、超声平面外辅助定位与传统触摸定位法动脉穿刺置管术在麻醉中的应用效果。方法:180例需行动脉穿刺置管监测有创血压的择期或急诊手术患者,随机分为6组(n=30):高年资传统触摸组(GC组)、高年资平面内组(GN组)、高年资平面外组(GW组)、低年资传统触摸组(DC组)、低年资平面内组(DN组)、低年资平面外组(DW组)。记录一次穿刺成功率、总穿刺成功率、血肿发生率以及穿刺时间和穿刺总耗时。结果:高年资组:一次穿刺成功率GN组显著高于GC组(P <0. 01),血肿发生率、穿刺时间GN组和GW组显著低于GC组(P <0. 01),穿刺总耗时GN组和GW组显著高于GC组(P <0. 01),且GW组显著低于GN组(P <0. 01)。低年资组:一次穿刺成功率、总穿刺成功率DN组和DW组显著高于DC组(P <0. 05或P <0. 01),DN组显著高于DW组(P <0. 05);血肿发生率DN组和DW组显著低于DC组(P <0. 05或P <0. 01),DN组显著低于DW组(P <0. 05);穿刺时间DN组显著低于DC组和DW组(P <0. 05);穿刺总耗时DN组和DW组显著高于DC组(P <0. 05)。结论:相比传统触摸定位法,超声引导动脉穿刺置管的成功率高、并发症少。对高年资麻醉医师推荐使用超声平面外辅助定位法,对低年资麻醉医师推荐使用超声平面内引导法。
Objective：To compare the effects of ultrasound-guided localization in-plane, ultrasound-assisted localization out- of-plane and traditional touch localization for radial artery catheterization in anesthesia. Methods ：80 patients undergoing selective or emergency operations requiring arterial puncture and catheterization were randomly divided into 6 groups （ n ： 30 ） ： senior anesthesiologist and traditional touch group （ GC group）, senior anesthesiologist and ultrasonic in-plane group （ GN group）, senior anesthesiologist and ultrasonic out-of-plane group （GW group）, junior anesthesiologist and traditional touch group （DC group） and junior anesthesiologist and ultrasonic in-plane group （ DN group ）, and junior anesthesiologist and ultrasonic out-of-plane group （DW group）. The success rate of one puncture, total puncture success rate, incidence of hematoma, puncture time and total puncture time were recorded. Results ：The success rate of one puncture in the GN group was significantly higher than that in the GC group （ P 〈 0. 01 ）, the incidence of hematoma and puncture time in the GN group and GW group were significantly lower than those in the GC group （P 〈0. 01 ）, the total puncture time in the GN group and GW group were significantly higher than those in the GC group （ P 〈 0. 01 ）, and they were significantly lower in the GW group than those in the GN group （ P 〈 0. 01 ）,. The success rate of one puncture and total puncture in the DN group and DW group were significantly higher than those in the DC group （ P 〈 0. 05 or P 〈 0. 01 ）, they were significantly higher in the DN group than that in the DW group （ P 〈 0. 05 ） ; the incidence of hematoma in the DN group and DW group was significantly lower than that in the DC group （ P 〈 0. 05 or P 〈 0. 01 ）, they were significantly lower in the DN group than that in the DW group （P 〈 0. 05 ） ; the puncture time in the DN group was significantly lower than that in the DW group （ P 〈 0. 05 ）. The total puncture time in the DN group and DW group was significantly higher than that in the DC group （P 〈 0. 05 ）. Conclusion ： Compared with the traditional touch localization, ultrasound-guided arterial catheterization has a high success rate and fewer complications. For senior anesthesiologists, we recommend the use of ultrasound-assisted localization out-of-plane ; for junior anesthesiologists, we recommend the use of ultrasound-guided localization in-plane.
作者
樊雅玲
谭栎
陈旭
吴勇
FAN Yaling;TAN Li;CHEN Xu;WU Yong(Department of Anesthesia,Leshan People＇s Hospital,Leshan,Siehuan 614000,China;Department of Anesthesia,Siehuan Women＇s and Children＇s Hospital,Chengdu,Siehuan 610031,China)
出处
《现代临床医学》
2018年第6期427-430,共4页
Journal of Modern Clinical Medicine
关键词
超声
桡动脉穿刺
平面内
平面外
传统触摸定位法
radial artery puncture
in-plane
out-of-plane
traditional touch localization
作者简介
通信作者：樊雅玲，179842517@qq．com
