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超声技术改善重症监护病房(ICU)休克患者的桡动脉穿刺置管

Ultrasonic Technology Improves Radial Artery Puncture and Cannulation in Intensive Care Unit (ICU) Shock Patients.

作者信息

Li Xiuyan, Fang Guizhen, Yang Danhua, Wang Lanfang, Zheng Chunmei, Ruan Longjuan, Wang Lingcong

机构信息

Department of Intensive Care Unit (ICU), The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China (mainland).

Department of Nursing, The First Affiliated Hospital Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China (mainland).

出版信息

Med Sci Monit. 2016 Jul 11;22:2409-16. doi: 10.12659/msm.896805.

Abstract

BACKGROUND This study observed the efficacy of ultrasonic technique with out-of-plane orientation and in-plane guidance in radial artery puncture and cannulation in intensive care unit (ICU) shock patients to elucidate the effect of this technique on the security of cannulation. MATERIAL AND METHODS A total of 88 ICU shock patients, randomized into a palpation (control) group and an ultrasound (experimental) group, received continuous intravenous sedation and analgesia. The palpation group patients underwent radial artery cannulation using the traditional palpation pulsation approach, and the ultrasound group patients underwent radial artery cannulation under out-of-plane orientation and in-plane guidance using an ultrasonic apparatus. Data were recorded and compared between the 2 groups. RESULTS (1) The success rate of the first puncture in the ultrasound group and the palpation group was 80% and 42%, respectively (P<0.05). (2) The cannulation duration in the ultrasound group and the palpation group was 8.77±6.33 s and 28.7±26.33 s, respectively (P<0.01). (3) Incidence of hematoma and staxis around stoma in the ultrasound group was 2.5% and 5%, respectively, which was significantly lower than that in the palpation group, which was 20% and 32.5%, respectively (P<0.05). (4) Time to achieve the early goal-directed therapy in the ultrasound group and the palpation group was 306.73±39.98 min and 356.75±40.97 min, respectively (P<0.01). CONCLUSIONS Compared with the traditional method, radial artery cannulation with out-of-plane orientation and in-plane guidance is a quick and secure cannulation method and is appropriate for use in clinics.

摘要

背景 本研究观察了超声技术在重症监护病房(ICU)休克患者桡动脉穿刺置管中采用平面外定位及平面内引导的效果,以阐明该技术对置管安全性的影响。材料与方法 共88例ICU休克患者,随机分为触诊(对照)组和超声(实验)组,均接受持续静脉镇静镇痛。触诊组患者采用传统触诊搏动法进行桡动脉置管,超声组患者使用超声设备在平面外定位及平面内引导下进行桡动脉置管。记录并比较两组数据。结果 (1)超声组和触诊组首次穿刺成功率分别为80%和42%(P<0.05)。(2)超声组和触诊组置管时间分别为8.77±6.33秒和28.7±26.33秒(P<0.01)。(3)超声组造口周围血肿和出血发生率分别为2.5%和5%,明显低于触诊组的20%和32.5%(P<0.05)。(4)超声组和触诊组达到早期目标导向治疗的时间分别为306.73±39.98分钟和356.75±40.97分钟(P<0.01)。结论 与传统方法相比,平面外定位及平面内引导的桡动脉置管是一种快速、安全的置管方法,适合临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a29b/4954160/d1abcfb10ca1/medscimonit-22-2409-g001.jpg

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