超声探头移动引导血管穿刺在手臂输液港置管中的应用

doi:10.3761/j.issn.0254-1769.2020.11.016

摘要/Abstract

摘要：

目的探讨超声探头移动引导血管穿刺法在手臂输液港置管中的应用效果。方法采用便利抽样法,选取南京市某三级甲等医院83例恶性肿瘤患者,按入院时间先后顺序将2020年3月—6月42例植入手臂输液港的患者作为试验组,采用超声探头移动引导血管穿刺法置管;2019年6月—7月41例置入手臂输液港的患者作为对照组,采用常规超声引导下血管穿刺置管;比较两组首次血管穿刺成功率、导丝送入成功率、置管时间、穿刺时疼痛评分和术后即时并发症。结果试验组首次血管穿刺成功率（97.62%）高于对照组（78.05%）,试验组导丝送入成功率（97.62%）高于对照组（70.73%),试验组置管时间（16.50±1.70） min短于对照组（18.56±1.99） min,试验组疼痛评分（1.62±0.54）分低于对照组（2.56±0.74）分,差异均有统计学意义（P<0.05）。试验组和对照组术后即时并发症发生例数分别为1例和5例,两组比较,差异无统计学意义（P>0.05）。结论超声探头移动引导血管穿刺能够提高手臂输液港首次置管成功率,降低患者疼痛程度,缩短置管时间。

关键词: 完全植入式静脉输液港, 超声平面, 静脉穿刺, 静脉输液, 护理

Abstract:

Objective To explore the application effect of mobile ultrasound out-of-plane vascular puncture in the implantation of the arm port. Methods A total of 83 patients with malignant tumors were selected as research subjects in Nanjing by convenience sampling. From March to June 2020,42 patients were selected as the experimental group and received the mobile ultrasound out-of-plane vascular puncture method. From June to July 2019,41 admitted patients were selected as the control group and received the puncture by conventional ultrasound guidance. The success rates of the first vascular puncture and guide wire insertion,the time duration of successful catheter placement,the score of pain during the puncture,and arm port related early complications were compared. Results The success rate of first blood vessel puncture in the experimental group （97.62%） was higher than that of the control group （78.05%）. In the experimental group,the success rate of guide wire insertion（97.65%） was higher than it in the control group（70.73%）. The time duration of catheter placement in the experimental group was（16.50±1.70） min which was lower than that in the control group（18.56±1.99） min. The pain score of the experimental group（1.62±0.54） was lower than it in the control group（2.56±0.74）. All differences above were statistically significant （P<0.05）. Only 1 complication occurred in the experimental group,but there were 5 in the control group,and the difference between the 2 groups was not statistically significant（P>0.05）. Conclusion The mobile ultrasound out-of-plane vascular puncture method can improve the success rate of the first catheter placement of the arm port,reduce the pain of patients and shorten the time of puncture which is worthy of clinical application.

Key words: Totally Implantable Venous Access Port, Ultrasound Plane, Venipuncture, Intravenous Infusion, Nursing Care

岳朝丽,孙莉,徐海萍,王艳丽,刘扣英. 超声探头移动引导血管穿刺在手臂输液港置管中的应用[J]. 中华护理杂志, 2020, 55(11): 1697-1700.

YUE Chaoli,SUN Li,XU Haiping,WANG Yanli,LIU Kouying. Application of mobile ultrasonic out-of-plane vascular puncture in the installation of tube in arm port[J]. Chinese Journal of Nursing, 2020, 55(11): 1697-1700.

图/表 3

图1 超声探头移动引导血管穿刺示意图

Figure 1 Schematic diagram of sliding ultrasound out-of-plane vascular puncture

表1 两组一般资料比较[例（百分比,%）]

Table 1 Comparison of general information between the two groups

表2 两组置管情况比较

Table 2 Comparison of catheterization between two groups

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