超声引导下导引结合自由手穿刺技术在胎儿脐静脉穿刺中的应用

目的:探讨超声引导下导引结合自由手穿刺技术在胎儿脐静脉穿刺的实用性。方法:对1 032例有脐静脉穿刺指征的孕妇实施超声引导下导引结合自由手脐静脉穿刺,记录穿刺成功率、完成时间及并发症发生情况。结果:一次穿刺成功率98.38%,两次穿刺成功率100.00%;58%的患者在1 min内完成,87.70%的患者在2 min内完成,94.80%的患者在5 min内完成。胎儿心率发生变化者占4.17%;无感染、羊水栓塞、胎盘早剥、胎膜早破、死胎发生。结论:超声引导下导引结合自由手穿刺技术较超声引导下导引或超声引导下自由手穿刺技术行胎儿脐静脉穿刺成功率高、时间短、并发症少,是一种安全高效的经腹胎儿脐静脉穿刺方法。

Application of ultrasonic-guided guidance combined with freehand piercing technique for umbilical vein puncture

Objective:To explore the practical applicability of ultrasonic-guided guidance combined with freehand piercing technique for umbilical vein puncture.Methods:A total of 1 032 pregnant women with indications of umbilical vein puncture underwent ultrasonic-guided guidance combined with freehand piercing,the successful rate of puncture,completion time,and incidence rate of complications were recorded.Results:The successful rate of puncture after the first puncture was 98.38%,the successful rate of puncture after the second puncture was 100.00%;the puncture was completed within one minute in 58% of the patients,within two minutes in 87.70% of the patients,within five minutes in 94.80% of the patients;change of fetal heart rate was found in 4.17% of the patients;no infection,amniotic fluid embolism,placental abruption,premature rupture of fetal membranes,and stillbirth occurred.Conclusion:Compared with simple ultrasonic-guided guidance or simple freehand piercing technique,the successful rate of ultrasonic-guided guidance combined with freehand piercing technique is high,time-saving,and the complications are few,the method is a safe and efficient transabdominal fetal umbilical vein puncture way.