Mao Qingxiang, He Haitao, Lu Yuangang, Hu Yi, Wang Zhen, Gan Maoxiang, Yan Hong, Chen Liyong
Department of Anesthesiology, Daping Hospital, Army Medical University, 10 ChangjiangZhilu, Yuzhong District, Chongqing, 400042, China.
Department of Maxillofacial and Head and Neck Surgery, Daping Hospital, Army Medical University, Chongqing, China.
Sci Rep. 2021 Jan 15;11(1):1599. doi: 10.1038/s41598-021-81354-w.
The objective of this study was to identify the factors that complicate the needle visualization in ultrasound-guided in-plane needling procedures. Forty-nine residents were recruited and randomized to insert the simulated blood vessel with four different views including Neutral (the long axis of the probe along the visual axis and the ultrasonic beam vertical to the surface of gel phantom), 45°-rotation (45° angle between the long axis of probe and the operator's visual axis), 45°-tilt (45° angle between the ultrasonic beam and the surface of gel phantom) and 45°-rotation plus 45°-tilt of probe. Number of needle redirections, insertion time, and needle visibility were documented and compared for each procedure. When the residents faced with 45°-tilt view, the needle redirections (2 vs 0) and insertion time increased significantly (39 vs 16) compared with that of the Neutral view. When faced with 45°-rotation plus 45°-tilt view, the residents' performance decreased further as compared with that of the 45°-tilt view and the Neutral view. However, there was no performance difference between the Neutral view and 45°-rotation view. In conclusion, during ultrasound-guided in-plane procedures, tilting the ultrasound probe may increase the difficulty of needle-beam alignment.
本研究的目的是确定在超声引导下平面内穿刺操作中使穿刺针可视化变得复杂的因素。招募了49名住院医师，并随机分配他们在四种不同视野下穿刺模拟血管，这四种视野包括：中立位（探头长轴沿视轴，超声束垂直于凝胶体模表面）、45°旋转（探头长轴与术者视轴呈45°角）、45°倾斜（超声束与凝胶体模表面呈45°角）以及探头45°旋转加45°倾斜。记录并比较每种操作的穿刺针重新调整方向的次数、穿刺时间和穿刺针可视性。当住院医师面对45°倾斜视野时，与中立位视野相比，穿刺针重新调整方向的次数（2次对0次）和穿刺时间显著增加（39秒对16秒）。当面对45°旋转加45°倾斜视野时，与45°倾斜视野和中立位视野相比，住院医师的操作表现进一步下降。然而，中立位视野和45°旋转视野之间的操作表现没有差异。总之，在超声引导下平面内操作过程中，倾斜超声探头可能会增加穿刺针与超声束对齐的难度。
