摘要
背景与目的:超声引导下腘静脉穿刺是下肢静脉腔内手术的常用入路之一,目前多是采用俯卧位,但长时间的俯卧位手术会让患者感觉不适。因此,本研究探讨采用仰卧位在超声引导下穿刺腘静脉的可行性,并比较采取仰卧位和俯卧位两种方法的优劣。方法:将髂静脉狭窄性疾病患者随机分成两组,分别在仰卧位和俯卧位下使用超声引导进行腘静脉穿刺,分析术中穿刺所用时间、患者不适程度的视觉模拟评分(VAS)等指标以及术后并发症发生情况。结果:共纳入27例患者,其中仰卧位组14例(16条肢体),俯卧位组13例(16条肢体)。两组患者的基线资料及病变静脉处理方法差异均无统计学意义(均P>0.05)。仰卧位穿刺腘静脉所用的操作时间与俯卧位穿刺腘静脉所用的操作时间差异无统计学意义[3.7(3.4~6.2)min vs.4.2(3.5~4.4)min,P>0.05]。仰卧位组的VAS评分明显低于俯卧位组[2.0(1.0~2.8)vs.6.0(4.0~8.0),P<0.01]。仰卧位组有1例术后腘动脉分支出血,经过超声引导下压迫动脉破口后成功治愈。结论:与俯卧位穿刺腘静脉相比,仰卧位穿刺腘静脉不会延长手术时间,但明显减少了患者的不适感,因此,推荐临床使用。
Background and Aims: Ultrasound-guided popliteal vein puncture is one of the common approaches for the intravenous intervention of the lower limb veins. At present, the prone position is frequently used for this procedure. However, long-time prone-positioned surgery is uncomfortable for patients.Therefore, this study was performed to investigate the feasibility of ultrasound-guided popliteal vein puncture in the supine position and compare the advantages and disadvantages of supine and prone position.Methods: Patients with chronic venous disease were randomly assigned to two groups and underwent ultrasound-guided popliteal vein puncture in a supine or prone position, respectively. The variables, such as the operative time for popliteal vein puncture and visual analog score(VAS) for the degree of discomfort of patients and the incidence of postoperative complications, were analyzed.Results: A total of 27 patients with iliac vein stenosis were enrolled, including 14 cases(16 limbs) in the supine position group and 13 cases(16 limbs) in the prone position group. There were no significant differences in the baseline data and the treatment methods of the affected veins between the two groups of patients(all P>0.05). The operative time for popliteal vein puncture showed no significant difference between the supine position group and prone position group [3.7(3.4-6.2) min vs. 4.2(3.5-4.4) min, P>0.05]. The VAS value was significantly lower in supine position group than that in prone position group [2.0(1.0-2.8) vs. 6.0(4.0-8.0), P<0.01]. Bleeding from a branch of the popliteal artery occurred in one supine position group case, which was successfully cured by ultrasound-guided compression of the lesion.Conclusion: Popliteal vein puncture in the supine position does not prolong the operative time compared with prone position, but it can significantly reduce the discomfortable suffering of patients. So, it is recommended to be used in clinical practice.
作者
陈刚
洪翔
卢伟锋
陈洁瑛
洪诗钗
黄玉龙
陈艺辉
林越
谢新胜
王利新
符伟国
CHEN Gang;HONG Xiang;LU Weifeng;CHEN Jieying;HONG Shichai;HUANG Yulong;CHEN Yihui;LIN Yue;XIE Xinsheng;WANG Lixin;FU Weiguo(Department of Vascular Surgery,Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen,Fujian 361015,China;Department of Science Education,Xiamen Branch,Zhongshan Hospital,Fudan University,Xiamen,Fujian 361015,China;Department of Vascular Surgery,Zhongshan Hospital,Fudan University/Institute of Vascular Surgery,Fudan University,Shanghai 200032,China)
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2022年第12期1628-1635,共8页
China Journal of General Surgery
基金
国家自然科学基金资助项目(82270415)。
关键词
血管疾病
下肢
血管内操作
穿刺术
腘静脉
体位
Vascular Diseases
Lower Extremity
Endovascular Procedures
Punctures
Popliteal Vein
Posture
