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护士实施超声引导下插管成功的预测因素。

Predictors of success in nurse-performed ultrasound-guided cannulation.

作者信息

Chinnock Brian, Thornton Stephen, Hendey Gregory W

机构信息

Department of Emergency Medicine, Community Regional Medical Center, UCSF-Fresno Medical Education Program, Fresno, California 93701, USA.

出版信息

J Emerg Med. 2007 Nov;33(4):401-5. doi: 10.1016/j.jemermed.2007.02.027. Epub 2007 Jul 5.

Abstract

The objective of this study was to characterize factors affecting the success rate of nurse-performed ultrasound (US)-guided peripheral vein cannulation in difficult access patients. We prospectively enrolled patients who had two previous unsuccessful i.v. attempts. Nurses were trained in US-guided cannulation using a 7.5-MHz linear probe. The following characteristics were recorded: 1) reason for difficult access, 2) which upper arm veins could be sonographically visualized, 3) cannulation success, and 4) one- or two-person technique used. One hundred patients were enrolled. The cannulation success rate was 63%. Cannulation of the basilic vein was successful in 39 of 55 attempts (71%), whereas the success rate for the brachial vein was only 19 of 46 attempts (41%). The reason for difficult access and the one- or two-person technique did not affect success rate. The basilic vein was the best choice for cannulation, and the one-person technique was as successful as the two-person technique.

摘要

本研究的目的是确定影响在静脉穿刺困难患者中护士操作超声(US)引导下外周静脉置管成功率的因素。我们前瞻性地纳入了之前两次静脉穿刺尝试均未成功的患者。护士使用7.5兆赫线性探头接受超声引导下置管培训。记录了以下特征:1)静脉穿刺困难的原因,2)超声检查能看到哪些上臂静脉,3)置管成功情况,以及4)采用单人还是双人技术。共纳入100例患者。置管成功率为63%。55次尝试中有39次(71%)成功穿刺贵要静脉,而46次尝试中肱静脉的成功率仅为19次(41%)。静脉穿刺困难的原因以及单人或双人技术均不影响成功率。贵要静脉是穿刺的最佳选择,单人技术与双人技术的成功率相同。

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