外周浅静脉穿刺法的改进与应用

目的探讨护理专业学生易掌握且患者较满意的外周浅静脉穿刺法,提高外周浅静脉一次性穿刺成功率,减轻穿刺时的疼痛感,提高护理质量。方法将我校2008级本科护理专业120名学生随机分为观察组和对照组,每组各60名。对照组采用传统的外周浅静脉穿刺法,即传统持针柄法（拇指上、示指下,针柄与手背皮肤平行的持针柄法）与传统进针角度（针头与皮肤呈20°～30°角度进针）;观察组采用增大角度持针柄法（拇指上、示指下,针柄与手背皮肤呈45°角）与增大角度进针法（针头与皮肤呈30°～45°角,并保持该角度将整个针尖斜面快速穿刺入血管,进针深度为2～3 mm,然后放平针头沿血管走向平行进针0.5～1.0 cm）。比较两组学生外周浅静脉一次性穿刺成功率及穿刺时的疼痛程度。结果观察组外周浅静脉一次性穿刺成功率高于对照组（P〈0.01）,且疼痛感明显低于对照组（P〈0.01）。结论外周浅静脉穿刺教学中采用增大角度持针柄法与增大角度进针法实用性和可行性较好,能提高外周浅静脉一次性穿刺成功率,减轻穿刺时的疼痛感。

Improvement and application of peripheral superficialvenepuncture

Objective To explore a wield and satisfactory method of peripheral superficial venepuncture for nursing students in order to improve the one-time achievement ratio of venepuncturerelieve and relieve patients′ pain and improve the quality of care.Methods 120 undergraduate nursing students in 2008 in our school were randomly divided into control group(60 cases) and observation group(60 cases).The conventional needle holding method(hold the needle horizontally with skin using thumb and forefinger) and the conventional pricking angle(insert the needle at the angle of 20°-30°) were used in the control group.And the big angle needle holding method(hold the needle holder at the angle of 45° with skin using thumb and forefinger) and the big angle pricking method(insert the needle at the angle of 30°-45°,lower the needle horizontally with the skin and push it for 0.5-1.0 cm following the vein direction) were used in the observation group.Pain response and achievement ratio of venepuncture were observed between the two groups.Results Compared with the conventional method,the degree of pain was less(P < 0.01) and the achievement ratio of venepuncture was greater(P <0.01) by using the modified method of peripheral superficial venepuncture.Conclusion The modified peripheral superficial venepuncture method(the big angle needle holding and the big angle pricking method) has good practicality and feasibility,which can improve the achievement ratio of venepuncture and alleviate the pain of skin tissue injury.