低龄儿童血液净化中血管穿刺技术的改良

目的 探索低龄儿童血液净化中临时性血管通路建立的技术特点,提高婴幼儿血液净化成功率。方法对照传统的采用16G针头直接穿刺股静脉与改良技术采用5mL注射器及肝素盐水套紧16G针头引导刺入股静脉方法,对其穿刺时间、成功率、流出道血流量、血管并发症等指标进行比较。结果 A组采用新法19例全部股静脉穿刺成功,血管穿刺平均时间(12±5)分,流出道血流量通畅,血管并发症少。B组采用旧法穿刺21例股静脉穿刺成功14例(66.6%),失败者改用颈静脉穿刺或采用静脉切开法。穿刺平均时间为(45±19)分钟,其它指标均低于A组,P<0.01。结论 改良后的血管穿刺技术可提高婴幼儿血管穿刺成功率和血液净化效果。

An Improved Puncture Technique of Blood Vessels on Hemodialysis in Young Children

objective To investigate the technical characteristics of constructing temporaryvascular access and to increase success rate of hemodialysis in young children.Methods In controlgroup (group A) puncturing femoral vein with 16G needle directly and in experimental group (group B)puncturing femoral vein with 16G needle harnessed and led by 5ml injector which was filled withheparinized normal saline.Comparing the time of puncture,success rate, blood flow of outflow tract,timeof vascular access retaining,vacsular complications in both group.Results All femoral venipuncturewere successful in 19 cases in group A,average time of puncture was 12?min,blood flow of outflow tractunimpeded, vacsular compliction fewer.14 cases in 21 cases in group B were successful(66.7%),centralvenipuncture or venisection were used in cases whose femoral vein were punctured unsuccessfully. Averagetime of puncture was 49?9min and other index lower than those in group A,p<0.01. Conclusion Improvedvenipuncture technique can increase success rate of venipuncture and effect of hemodialysis in youngchildren.