Horiuchi Toshinori, Okuda Chie, Kurita Naoko, Yamaguchi Ayako, Kitagawa Kazuhiko, Takeda Masafumi, Sha Keiichi, Nagahata Toshihiro
Department of Anesthesia, Bellland General Hospital, 500-3 Higashiyama, Naka-ku, Sakai, Osaka, 599-8247, Japan.
J Anesth. 2017 Oct;31(5):789-793. doi: 10.1007/s00540-017-2381-8. Epub 2017 Jun 20.
In ultrasound-guided central venous catheterization, there is no standard technique either for the needle tip visualization or for the adequate needle angle and entry to the skin with short-axis view under out-of-plane technique. In the present study, we propose a novel technique named "stepwise flashing with triangulation", and the efficacy of this technique is assessed. Before and after a didactic session in which the technique was explained, 12 novice residents were asked to position the needle tip on or into the imitation vessels and to avoid deeper penetration by using an agar tissue phantom with ultrasound guidance. "Stepwise flashing" technique was for stepwise visualization of the needle tip, and "triangulation" technique was for adequate needle angle and entry to the skin. After the session, the success rate was increased and a deeper penetration rate was decreased. This technique will help us to facilitate vascular access and to avoid complications in clinical settings.
在超声引导下的中心静脉置管中，无论是在平面外技术的短轴视图下进行针尖可视化，还是确定合适的进针角度及进皮点，均没有标准技术。在本研究中，我们提出了一种名为“三角定位逐步闪烁”的新技术，并评估了该技术的有效性。在进行了该技术讲解的教学课程前后，12名新手住院医师被要求在超声引导下，将针尖置于模拟血管上或刺入模拟血管，并使用琼脂组织模型避免进针过深。“逐步闪烁”技术用于逐步实现针尖可视化，“三角定位”技术用于确定合适的进针角度及进皮点。课程结束后，成功率提高，进针过深率降低。这项技术将有助于我们在临床环境中更便捷地建立血管通路并避免并发症。
