超声可视引导足背动脉穿刺置管的临床观察

目的：研究超声可视引导下进行足背动脉穿刺置管的安全性和有效性。方法：气管内全麻下进行择期鼻窦手术患者60例,随机数字表法均分为传统手指触摸组(T组,n=30)和超声可视引导组(S组,n=30)。T组采用食指指腹触摸足背动脉搏动以定位穿刺点及进针方向；S组采用床旁超声可视引导留置针穿刺足背动脉。记录并比较两组的1次穿刺置管、2次穿刺置管、3次穿刺置管的成功例数,穿刺置管失败例数,1次穿刺置管成功操作时间以及失败原因,局部血肿发生例数。结果：两组患者的一般资料无统计学意义(P>0.05)。与T组比较,S组的穿刺置管总次数显著性减少(P<0.05),尤其1次穿刺置管成功率更高(63.3% vs. 93.3%,P<0.05),但1次穿刺置管操作时间更长(1.2±0.9min vs. 2.3±1.1min,P<0.05)。与S组比较,T组的穿刺置管总成功率明显较低(100% vs. 80%,P<0.05),且局部血肿例数更多(1 vs. 8,P<0.05)。结论：超声可视引导显著提高足背动脉穿刺置管成功率,减少反复多次穿刺对血管、组织的损伤。

Clinical research of bedside ultrasound-guided dorsalis pedis arterial catheterizationOUYANG Hui-bi, CAI Jian-li, LI Zhi-peng, LIU Chui-liang

Objective The aim of this study was to investigate the safety and efficiency of ultrasound guided arterial catheterization on the dorsalis pedis puncture. Methods Sixty patients who were scheduled for sinus operation with general anesthesia were randomized into two equal-sized groups: traditional palpation group (Group T) and ultrasound group (Group S). Group T catheterized using traditional method with forefinger to palpate dorsalis pedis pulse for surface localization and direction of needling, and Group S undergone a real-time bedside ultrasound-guided in-plane catheterization. The frequency of successful catheterization, the time of successful catheterization at the first time, the failure number of puncture catheterization attempts, the cause of the failure, the number of local Hematomas were recorded and compared between the two groups. Result There were no differences in age, body weight, sex composition between the two groups (P > 0.05). Compared with Group T, the number of puncture catheterization attempts were significantly higher(63.3% vs. 93.3%,P < 0.05), and the total success rate of catheterization were significantly higher in Group S (80% vs. 100%,P<0.05). The success rate of catheterization at the first puncture attampt was significantly higher in Group S than Group T (P < 0.05). The time required for successful catheterization at the first time in Group S was longer than Group T (P<0.05). There was significant difference in puncture site local hematomas between the Group T and Group S (8 vs. 1,P<0.05). Conclusion Ultrasound-guided dorsalis pedis arterial catheterization can effectively improve the success rate of puncture catheterization and decreases the number of puncture attempts for avoiding the complications such as local hematomas and tissue damage.