摘要
目的分析代谢综合征患者BMI与肘部静脉:头静脉、正中静脉、贵要静脉分级表达、皮下深度、血管直径之间的相关关系,为肥胖患者外周静脉的精准穿刺提供方法和理论依据。方法2021年1—10月选择南京医科大学第一附属医院767例行胃减容术的代谢综合征患者为研究对象,进行回顾性队列研究。按BMI水平的四分位数Q_(1),M,Q_(3)分为A、B、C、D组4组,超声测量肘部头静脉、正中静脉、贵要静脉皮下深度和血管直径,依据浅静脉分级标准对3支静脉进行评估分级,分析BMI与肘部3支静脉皮下深度和血管直径的相关关系并统计穿刺方法和穿刺次数。结果BMI水平与贵要静脉皮下深度及血管直径无显著相关(r=0.041、0.046,均P>0.05);与头静脉(r=0.275、0.117)和正中静脉(r=0.236、0.148)的皮下深度和血管直径均呈正相关(均P<0.05),且显直线回归关系(OR值为1.013~1.031,均P<0.05)。具备直视下条件直接穿刺187例,一次穿刺成功率86.63%(162/187);25例直视穿刺失败者及580例缺乏直视下穿刺条件者在超声引导下完成静脉穿刺,一次穿刺成功率为98.51%(596/605)。结论代谢综合征患者随着BMI水平的增加,头静脉和正中静脉皮下深度及血管直径均增加,静脉暴露表达困难。超声引导下的可视化静脉穿刺更为精准,置管更加可靠。
Objective To analyze the correlation between body mass index(BMI)and the graded expression,subcutaneous depth,and diameter of elbow veins(cephalic vein,median vein,basilic vein)in patients with metabolic syndrome,to provide a method and theoretical basis for precise puncture of peripheral veins in obese patients.Methods From January to October 2021,a total of 767 patients with metabolic syndrome with gastric volume reduction were selected as the study subjects by retrospective cohort study from the first Affiliated Hospital of Nanjing Medical University.According to the quartile Q_(1),M and Q_(3)of BMI level,they were divided into four groups:group A,group B,group C and group D.The subcutaneous depth and diameter of the cephalic vein,median vein and basilic vein were measured by B-ultrasound,and the three veins were evaluated and graded according to the grading criteria of superficial veins.The correlation between BMI and the subcutaneous depth and diameter of the three elbow veins was analyzed,and collected data such as puncture method and puncture times.Results There was no significant correlation between BMI and subcutaneous depth and vessel diameter of the basilic vein(r=0.041 and 0.046,both P>0.05),the level of BMI was positively correlated with the subcutaneous depth and diameter of cephalic vein(r=0.275 and 0.117,both P<0.05)and median vein(r=0.236 and 0.148,both P<0.05),and a linear regression relationship was found(OR values were 1.013-1.031,all P<0.05).187 cases had direct puncture conditions under direct vision,and the success rate of one puncture was 86.63%(162/187).Venipuncture was completed under the guidance of B-mode ultrasound for 25 cases with failure under direct vision and 580 cases without direct puncture conditions under direct vision,the success rate of one puncture was 98.51%(596/605).Conclusions With the increase of BMI level in patients with metabolic syndrome,the depth and diameter of both cephalic vein and median vein increase,venous exposure is difficult to express.The visual vein pun
作者
曹霞
张剑英
梁辉
管蔚
季萍
刘畅
姚茵
Cao Xia;Zhang Jianying;Liang Hui;Guan Wei;Ji Ping;Liu Chang;Yao Yin(Department of Anesthesia and Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)
出处
《中国实用护理杂志》
2023年第23期1767-1772,共6页
Chinese Journal of Practical Nursing
基金
吴阶平医学基金会临床科研专项资助基金(320.2710.1807)。
关键词
代谢综合征
浅静脉分级
体重指数
静脉穿刺
Metabolic syndrome
Superficial vein grading
Body mass index
Venipuncture
