摘要
目的:评价超声结合导引丝动脉穿刺法在困难桡动脉穿刺置管中应用的可行性,并探讨其安全性及价值。方法:选择需行有创动脉监测306例手术患者,随机分成:A组:采用传统触摸脉搏搏动盲法,使用普通动脉穿刺针采取直接穿透法行桡动脉穿刺置管;B组:采用传统触摸脉搏搏动盲法,使用带导丝的动脉穿刺导管组行桡动脉穿刺置管;C组:直接采用B超引导的普通动脉穿刺针行桡动脉穿刺置管;D组(n=36):为上述三组患者穿刺失败后,采用B超结合导丝引导下的桡动脉穿刺置管。分别记录各组患者的首次穿刺成功率、总体成功率、穿刺次数、穿刺时间。记录桡动脉血肿等并发症的发生情况。结果:A组15例穿刺置管失败,B组14例穿刺置管失败,C组7例穿刺置管失败,D组35例穿刺置管成功;C组首次穿刺成功率高于A组、B组,而穿刺时间明显少于A组和B组,且总成功率显著高于A组(P<0.05),而穿刺次数明显少于A组(P<0.05);D组首次穿刺成功率、总穿刺总功率分别高达77.8%及97.2%。结论:超声辅助技术可以提高桡动脉置管成功率,短轴平面外+长轴平面内超声技术联合导引丝动脉穿刺置管法成功率更高,亦是直接桡动脉穿刺失败后的有效补救方法之一。
Objective:To evaluate the feasibility of ultrasound-guided peripheral arterial puncture combined with the outer guidewire arterial puncture,and to investigate its safety and prognosis.Methods:A total of 306 cases who need invasive arterial monitoring were randomly divided into three groups:Group A used the traditional puncturing method,Group B were guided by ultrasound,and Group C were guided by guidewire.The puncturing times and duration,first puncture successful rate,total successful rate,and complications were compared.All the failed cases(Group D)after pucturing received combined ultrasound and guidewire method,and the above results were recorded.Results:Group C showed the highest successful puncture rate and fewest pucturing time in the three groups(P<0.05).The success rate of the first puncture and total puncture were significantly increased in D group as 77.8% and 97.2%respectively.Conclusion:Ultra-sound technology combined with ultra guidewire arterial puncture can lead to higher success rate,and which is also one of remedy directly after radial artery puncture failure.
出处
《武汉大学学报（医学版）》
CAS
2017年第2期324-328,共5页
Medical Journal of Wuhan University
关键词
超声引导
动脉穿刺导管
桡动脉穿刺
Ultrasound Guidance
Arterial Catheter
Radial Artery Puncture
