摘要
目的探讨在脓毒症休克患者中床旁超声引导颈内静脉穿刺置管的安全性和有效性。方法选取承德医学院附属医院重症医学科需要进行颈内静脉穿刺置管的脓毒症休克患者100例,随机分为对照组和试验组,每组50例。对照组采用传统的解剖标志点盲探颈内静脉穿刺置管,试验组采用床旁超声定位引导颈内静脉穿刺置管,比较两种方法的成功率、穿刺时间及并发症发生率。结果对照组一次成功率及总成功率均明显高于对照组[一次成功率88.0%(44/50)、48.0%(24/50)、总成功率98.0%(49/50)、76.0%(38/50),P<0.05],穿刺时间明显缩短[(7.3±1.5)、(11.5±2.8)分,P<0.05],并发症发生率显著降低[8.0%(4/50)、26.0%(13/50),P<0.05],且未增加导管相关性血流感染的风险[8.0%(4/50)、6.0%(3/50),P>0.05]。结论在脓毒症休克患者中床旁超声引导下颈内静脉置管成功率高,操作时间短,并发症发生率低,安全性好,值得推广。
Objective To investigate the clinical efficiency and safety of bedside ultrasound-guided central venous catheterization in patients with septic shock. Methods One hundred patients with septic shock who underwent internal jugular vein catheterization in our hospital were randomly divided into two control group（ n = 50） and experimental group（ n = 50）.The patients in control group were treated by blindly traditional anatomical landmark puncture to conduct internal jugular vein catheterization,however,the patients in experimental group were treated by bedside ultrasound-guided central venous catheterization. The success rate of puncture,time of catheterization and incidence of complications were observed and compared between two groups. Results The one time success rate of puncture and total success rate in experimental group88. 0%（ 44/50） and 98. 0%（ 49/50）,respectively,which were significantly higher than those [48. 0%（ 24/50） and 76. 0%（ 38/50）,respectively in control group（ P〈0. 05） ]. Moreover the time of catheterization in experimental group was significantly shorter than that in control group [（ 7. 3 ± 1. 5） min vs（ 11. 5 ± 2. 8） min,P〈0. 05],and the incidence rate of complications in experimental group was significantly lower than that in control group [8. 0%（ 4/50） vs. 26. 0%（ 13/50）,P〈0. 05],without increasing the risk of catheterization related bloodstream infection [8. 0%（ 4/50） vs 6. 0%（ 3/50）,P〈0. 05]. Conclusion The bedside ultrasound-guided internal jugular vein catheterization in treatment of septic shock has the advantages of higher success rate,shoter operation time and less incidence rate of related complications,with good safety,therefor,it is worthy of clinical application.
作者
段立娟
夏嘉鼎
赵凯峰
严晓薇
滑立伟
DU-AN Lijuan;XIA Jiading;ZHAO Kaifeng(Affiliated Hospital of Chengde Medical College,Hebei,Chengde 067000,China)
出处
《河北医药》
CAS
2018年第19期2993-2995,共3页
Hebei Medical Journal
基金
承德市科学技术研究与发展指导计划项目(编号:201601A029)
关键词
床旁超声
颈内静脉
脓毒症休克
中心静脉穿刺置管
bedside ultrasound
internal jugular vein
septic shock
central venous catheterization
