超声引导桡动脉穿刺术的临床应用

目的探讨超声引导桡动脉穿刺术的临床应用。方法选择厦门市第二医院集美总院需行桡动脉穿刺置管后持续监测动脉血压及多次动脉采血行血气分析患者61例，随机分为传统解剖定位即盲探法（盲探穿刺，BP）31例，超声引导（UG）桡动脉穿刺组30例，比较两组首次穿刺成功率、总成功率、并发症（出血、血肿、血管痉挛）发生率、总操作时间。结果UG组首次穿刺成功率为80％（24／30），与BP组51．6％（16／31）比较差异有统计学意义（P〈0．05）。UG组总成功率为93．4％（28／30），与BP组70．9％（22／31）比较差异有统计学意义（P〈0．05）。UG组穿刺过程中发生血肿2例，桡动脉痉挛1例，并发症发生率为10％（3／30），BP组血肿3-例，出血1例，桡动脉痉挛2例，并发症发生率为19．4％（6／31），两组比较差异有统计学意义IP〈0．05）。UG组总操作时间（1．4±0．4）min与BP组（3．0±1．2）min比较差异有统计学意义（P〈0．05）。结论超声引导桡动脉穿刺法可以提高首次穿刺成功率和总成功率，减少出血、血肿、痉挛等并发症发生率，减少总操作时间，临床效果优于盲探穿刺法。

Clinical application of ultrasound guided radial arterial cannulation

Objective To observe the clinical efficacy of ultrasound-guided（UG） radial arterial cannulation. Methods Sixty-one patients in Gimei General Hospital of the Second Hospital of Xiamen undergoing radical artery cannulation were randomly assigned to ultrasound-guilded group （UG group, n = 30） and blindly puncture group （ BP group, n = 31 ）. Patients would underwent arterial catheterization for invasive monitoring were included in this study. The observative items included the success rate of cannulation at the first attemp, the number of attempts total, the time taken from skin puncture to arterial catheter insertion and overall success rate, complications, etc. Results There were no statistically signif- icant differences in age, weight, depth and diameter of artery between the two groups. UG puncture groups was successfully compared to BP group at the first and overall success rate （ P 〈 0.05 ）, lower complications （ P 〈 0.05 ）, shorter puncture time （ P 〈 0.05 ） ： Conclusions Ultrasound guided radial ar-terial cannulation can increase the rate success at first and overall, can improve the success rate, reduce complications and decrease the need of puncture time.