不同超声辅助方法颈内静脉穿刺置管在急危重症患者中的应用
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摘要
目的比较超声体表定位标记和全程实时超声引导两种超声辅助颈内静脉穿刺置管方法在急危重症患者中的应用效果。方法选取颈内静脉穿刺置管急危重症患者100例,随机均分为A组(超声定位标记组)和B组(实时超声引导组),每组50例。A组穿刺前超声体表定位标记法穿刺置管,B组全程实时超声引导法穿刺置管。观察两组颈内静脉穿刺置管总成功率、穿刺置管时间及成功穿刺颈内静脉时间、机械并发症发生率。结果两组在穿刺总成功率差异无统计学意义(P>0.05),A组置管时间及成功穿刺颈内静脉时间较B组更短(P<0.05),B组机械并发症发生率较A组更低(P<0.05)。结论静态定位标记与实时超声引导两种超声辅助颈内静脉穿刺置管方法用于急危重症患者同样有效,都提高穿刺成功率,适用于临床推广,静态定位标记法操作有时间短的优势,实时超声引导法更加安全。
Objective To compare the effectiveness of surface localization by Ultrasonic orientation and real-time ultrasound guided puncture in critical patients. Methods 100 critical patients with central venous catheterization were selected and randomly divided into group A(ultrasound orientation) and group B(ultrasound guidance), 50 cases in each group. Body surface localization was marked by ultrasound before puncture in Group A(static positioning), real-time ultrasound guidance was performed during the operation(real time ultrasound guidance) in group B. Success rate, catheterization time, puncturing time, complications were recorded. Result There was no statistical difference between two groups in success rate(P >0.05). In Group A, time of catheterization and internal jugular vein puncture was less than those in group B(P <0.05). Group B had less complication than group A(P <0.05). Conclusion There is the same effectiveness between static ultrasound positioning and real time ultrasound guidance applied in critical patients, success rate of puncturing are both improved, and they both are appropriate to promote to clinical practice. Static ultrasound positioning needs less time.Real time guidance is safer.
Objective To compare the effectiveness of surface localization by Ultrasonic orientation and real-time ultrasound guided puncture in critical patients. Methods 100 critical patients with central venous catheterization were selected and randomly divided into group A(ultrasound orientation) and group B(ultrasound guidance), 50 cases in each group. Body surface localization was marked by ultrasound before puncture in Group A(static positioning), real-time ultrasound guidance was performed during the operation(real time ultrasound guidance) in group B. Success rate, catheterization time, puncturing time, complications were recorded. Result There was no statistical difference between two groups in success rate(P >0.05). In Group A, time of catheterization and internal jugular vein puncture was less than those in group B(P <0.05). Group B had less complication than group A(P <0.05). Conclusion There is the same effectiveness between static ultrasound positioning and real time ultrasound guidance applied in critical patients, success rate of puncturing are both improved, and they both are appropriate to promote to clinical practice. Static ultrasound positioning needs less time.Real time guidance is safer.
引文
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[5]彭深渠,古昌剑,曹振刚,张淑芳,张翔,张新峰.肥胖患者血管横切平面内法颈内静脉穿刺置管的可行性[J].新疆医学,2018,48(01):71-73.
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[8]黄雪芳,曹婷,黄敬心,等.彩超引导下与盲穿留置颈内静脉血液透析导管效果比较[J].广东医学,2014,35(18):2893-2895.
[9]陈碧新.两种超声辅助方法在引导颈内静脉穿刺置管的效果比较[J].现代实用医学,2016,28(3):305.
[2]吴小君,王琼香.超声引导下颈内静脉穿刺置管术在急诊应用体会[J].心血管病防治知识,2017,1:60.
[3]肖扬,李伟彦,陈丽芬,等.实时超声引导成人颈内静脉穿刺置管的应用价值[J].临床超声医学杂志,2015,17(1):58.
[4]王忠义,陈金辉,张同军,等.喉罩通气患者行超声定位引导与解剖定位法颈内静脉穿刺的比较[J].河北医药,2016,38(9)1393.
[5]彭深渠,古昌剑,曹振刚,张淑芳,张翔,张新峰.肥胖患者血管横切平面内法颈内静脉穿刺置管的可行性[J].新疆医学,2018,48(01):71-73.
[6]罗超,权哲峰,池萍,等.超声中线定位方法用于颈内静脉穿刺置管术的临床研究[J].临床麻醉学杂志,2015,31(4):329-331.
[7]肖扬,李伟彦,陈丽芬,等.实时超声引导成人颈内静脉穿刺置管的应用价值[J].临床超声医学杂志,2015,17(1):5759.
[8]黄雪芳,曹婷,黄敬心,等.彩超引导下与盲穿留置颈内静脉血液透析导管效果比较[J].广东医学,2014,35(18):2893-2895.
[9]陈碧新.两种超声辅助方法在引导颈内静脉穿刺置管的效果比较[J].现代实用医学,2016,28(3):305.