摘要
目的探讨超声引导技术在婴儿桡动脉穿刺置管中的应用价值。方法选择80例1岁以下需行桡动脉穿刺置管的手术患儿,随机分为超声引导组(n=40)和传统触摸组(n=40)。超声引导组采用超声引导法进行穿刺和置管,传统触摸组采用指尖触摸法进行定位和穿刺置管,分别记录每组患儿的穿刺时间、穿刺次数,比较两组的首次穿刺成功率、总成功率、首次穿刺成功时间、总穿刺时间、穿刺次数及套管针使用数量。结果超声引导组首次穿刺成功率和总成功率分别为72.5%和97.5%,传统触摸组首次穿刺成功率和总成功率分别为50%和80%,差异均有统计学意义(P<0.05)。超声引导组有1例穿刺失败,更换穿刺部位后穿刺成功。传统触摸组有8例穿刺失败,改超声引导后全部穿刺成功。超声引导组总穿刺时间(66.6±56.9)s,明显短于传统触摸组的(120±94.9)s,差异有统计学意义(t=3.052,P=0.003)。两组首次穿刺成功所需时间分别为(36.3±16.2)s和(38.3±19.1)s,差异无统计学意义(P>0.05)。超声引导组总穿刺次数少于传统触摸组[1(1~2)vs.1.5(1~3)](χ^2=3.900,P<0.05)。与传统触摸组相比,超声引导组使用穿刺针数量较少[1(1~1)vs.1(1~2)],差异有统计学意义(χ^2=3.464,P<0.05)。传统触摸组有7例(17.5%)出现动脉血肿及出血等并发症,而超声引导组仅1例(2.5%)出现并发症,差异有统计学意义(χ^2=4.507,P<0.05)。结论围术期婴儿行桡动脉穿刺置管时使用超声引导技术可有效提高穿刺成功率,缩短穿刺时间,降低穿刺相关并发症,值得临床推广应用。
Objective To explore the ultrasonically-guided radial arterial cannulation in infants. Methods Eighty surgical infants aged 1-12 months requiring an arterial catheter were randomly divided into ultrasonically-guided and classic palpation groups.The ultrasonic device was employed for radial arterial cannulation in ultrasonically-guided group.And,for infants in classic palpation group,classic palpation was used for determining the position of radial artery.Period of puncture time and numbers of attempts were recorded.And initial attempt success rate,total success rate,time to success,time to initial attempt and mean number of attempts were compared between two groups. Results Compare to the classic palpation group,initial attempt rate and total success for ultrasound guided group were higher (72.5% vs 50%,97.5% vs 80%)( P <0.05).One failed puncture case was present in ultrasonically-guided group and punctures succeed after replacing puncture site.In classic palpation group,all eight failed cases during puncturing were successfully performed under ultrasonic guidance.The mean time to success for ultrasonically-guided group were shorter than that for classic palpation group[(66.6±56.9) vs (120±94.9)s, t =3.052, P =0.003].Time to initial attempt success was not significantly different between two groups[(36.3±16.2) vs (38.3±19.1)s]( P >0.05).The frequency of attempts for ultrasonically-guided group was less than those for classic palpation group[1(1~2) vs 1.5(1~3)],(χ^2=3.900, P <0.05 ).The number of needles used in ultrasonically-guided group was less than those in classic palpation group[1(1~1) vs 1(1~2)](χ^2=3.464, P <0.05),cannulation complications were lower in ultrasonically-guided group than those in classic palpation group (1 vs 7)(χ^2=4.507, P <0.05). Conclusion The application of ultrasonically-guided technology is reliable for radial artery cannulation in infants.It may improve the success rate,allow for faster cannulation and result in fewer complications.
作者
朱义
杜真
汪丽娜
陈政
肖婷
屈双权
Zhu Yi;Du Zhen;Wang Lina;Chen Zheng;Xiao Ting;Qu Shuangquan(Department of Anesthesiology,Hunan Children's Hospital,Changsha 410007,China)
出处
《临床小儿外科杂志》
CAS
2019年第8期699-702,共4页
Journal of Clinical Pediatric Surgery
基金
湖南省科技计划项目基金资助(编号:S2012F1023)
