下肢深静脉顺行造影中改良造影剂注射方法的效果

目的探讨改良造影剂注射方法在下肢深静脉顺行造影中的应用价值。方法将271例患者（共340条下肢）按时间段分为改良组（170条下肢）和对照组（170条下肢），改良组在踝部上方5cm处扎紧止血带，逆心穿刺踝部旁侧的大隐静脉，采用遥控式高压注射器注射造影剂；对照组向心穿刺拇趾基底部旁侧的浅静脉或足背浅静脉远端，徒手注射对比剂。并对两组的静脉穿刺一次成功率、患者的疼痛感觉、推注造影剂过程中血管渗漏率、下肢深静脉显影效果进行对比。结果两组静脉穿刺一次成功率、推注造影剂时患者的疼痛感觉、推注造影剂过程中血管渗漏率差异有显著性意义（P〈0.01），下肢深静脉显影效果无统计学意义（P〉0.05）。结论下肢深静脉顺行造影时采用逆心穿刺大隐静脉后连接遥控式高压注射器注射造影剂可提高穿刺成功率，减轻患者的疼痛，减少血管渗漏率，节约医疗成本，并可降低护理风险和减少护士受X线直接辐射损伤。

Outcome of Improved Contrast Medium Injection Method in Anterograde Phlebography of Deep Vein of Lower Limbs

Objective To discuss the value of improved contrast medium injection method in anterograde phlebography of deep vein of lower limbs.Methods A total of 271 patients(340 extremities) were divided into 2 groups: control group(170 extremities) and improved group(170 extremities).Patients in improved group were pricked from the great saphenous vein around the ankle by antidromcordis after straining the tourniquet tightly above the ankle for 5 cm,then the contrast medium was injected using remote high pressure syringe.Patients in the control group were pricked from superficial vein around the first digit or the distal end of superficial vein in the dorsalis pedis,then the contrast medium was injected by hand.The first pricking achievement ratios,pain,leakage ratios from the vessel,the phlebography outcomes of deep vein in limbs were all compared between the 2 groups.Results There were marked difference in the first pricking achievement ratios,pain,and leakage ratios from the vessel between the 2 groups(P<0.01).However,there were no statistical difference in the phlebography outcome.Conclusion Pricking from the great saphenous vein by antidromcordis and injection by remote high pressure syringe can raise the pricking achievement ratios,reduce pain and the leakage ratios from the vessel,decrease the cost in,lower the risk in nursing,and decrease the radiation injury in nurses.