摘要
目的探讨超声预定位方法在重症监护病房住院医师实施颈内静脉置管术中的应用价值。方法将12名重症医学科住院医师分为对照组和超声组,每组6名医师,每名医师检查15例患者,共计180例患者。对照组应用传统体表解剖标志定位法进行颈内静脉置管组,超声组应用超声预定位方法进行颈内静脉置管;比较两组颈内静脉置管成功率、置管时间、第一针穿刺成功率、主治医师替换操作率及并发症发生率。结果超声组颈内静脉置管成功率和第一针穿刺成功率均显著高于对照组,颈内静脉置管时间及主治医师替换操作率均低于对照组,差异均有统计学意义(均P<0.05)。超声组置管并发症总发生率和误穿动脉的发生率显著低于对照组(4.44%vs.21.11%,3.33%vs.13.33%),差异均有统计学意义(均P<0.05),其他并发症如气胸、局部血肿及导管相关性血流感染的发生率两组比较差异均无统计学意义。结论超声预定位方法可以显著提高重症监护病房住院医师颈内静脉置管术的穿刺成功率,缩短置管时间,降低主治医师替换操作率,同时减少置管并发症的发生,具有重要临床应用价值。
Objective To investigate the application value of pre-procedure ultrasound in the process of inter jugular venous catheterization for intensive care unit(ICU)residents.Methods A total of 12 ICU residents were divided into control group(n=6,15 patients per resident and each patient was treated under inter jugular venous catheterization by the guidance of traditional landmark)and ultrasound group(n=6,15 patients per resident and each patient was treated under inter jugular venous catheterization by the guide of pre-procedure ultrasound).There were 180 patients involved in this study.The successful insertion rate,insertion time,first attempt successful cannulation rate,attending physician operation rate and the complication rate between two groups were compared.Results The successful insertion rate and first attempt successful cannulation rate in ultrasound group were significantly higher than those in control group,the insertion time and attending physician operation rate in ultrasound group were remarkably lower than those in control group(all P<0.05).The complication rate in ultrasound group was significantly lower than that in control group(4.44%vs.21.11%,P<0.05).The incidence of artery mistaken in ultrasound group was significantly lower than that in control group(3.33%vs.13.33%,P<0.05).There were no significant difference in other complication rate,including local hematoma,pneumothorax and catheter related blood infection rate between two groups.Conclusion The application of pre-procedure ultrasound in the process of inter jugular venous catheterization can improve the successful insertion rate and first attempt successful cannulation rate,decrease the insertion time,attending physician operation rate and complication rate,which has an important clinical application value.
作者
李昊
高兰
孙婧婧
闫晋琪
刘昱
刘红娟
余珊珊
石秦东
LI Hao;GAO Lan;SUN Jingjing;YAN Jinqi;LIU Yu;LIU Hongjuan;YU Shanshan;SHI Qindong(Department of Critical Care Medicine,the First Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710061,China)
出处
《临床超声医学杂志》
2018年第7期481-483,共3页
Journal of Clinical Ultrasound in Medicine
基金
西安交通大学第一附属医院院级教学改革研究项目(17YB01)
关键词
超声检查
颈内静脉穿刺置管术
重症监护病房
Ultrasonography
Inter jugular venous catheterization
Intensive care unit
