超声引导下桡动脉穿刺不同方法（短轴法和长轴法）与传统触诊法成功率的比较：一项前瞻性随机研究。
Comparison of Success Rates of Different Methods of Ultrasound-Guided Radial Artery Cannulation (Short-Axis and Long-Axis Methods) Against the Traditional Palpatory Method: A Prospective Randomized Study.
作者信息
Rajasekar Mounica, Sukumar Senthilkumar, Selvaraj Venkatesh
机构信息
Department of Anaesthesiology and Pain Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
出版信息
Turk J Anaesthesiol Reanim. 2022 Feb;50(1):52-58. doi: 10.5152/TJAR.2021.1364.
OBJECTIVE
Recent meta-analysis comparing the success rates of various methods of arterial cannulation in adult patients found heterogeneity in the available data. Hence, we did this study to evaluate and compare the success rate of palpatory method with that of ultrasound guided methods of radial artery cannulation. The aim is to compare the first-attempt success rate of the palpatory method with that of ultrasound-guided radial artery cannulation techniques, namely, the short-axis out-of-plane and the long-axis in-plane methods.
METHODS
This is a prospective, randomized, parallel-arm study. Ninety patients aged from 18 to 50 years (presenting for various surgeries requiring radial artery cannulation for invasive blood pressure monitoring or frequent arterial blood gas analysis) were divided into 3 groups. Each group had one of the 3 techniques of radial arterial cannulation, namely palpatory, short-axis ultrasound method, and long-axis ultrasound method. The parameters analyzed were first-attempt success rate, number of attempts needed, cannulation time, need for crossover of technique, and incidence of complications. Multivariate analysis was done with one-way ANOVA, with Tukey's post hoc test. For categorical data, the chi-square test was used. The probability value of .05 was considered as a significant level.
RESULTS
The first-attempt success rate was 76.7% in the long-axis method, 86.7% in the short-axis method, and 56.7% in the palpatory method. The short-axis method has been shown to have a shorter cannulation time, fewer attempts needed for successful cannulation, and lower need for crossover of techniques when the first 2 attempts fail.
CONCLUSIONS
We conclude that the ultrasound-guided short-axis method of radial artery cannulation is associated with higher first-attempt success rate compared to the traditional palpatory method.
目的
近期的荟萃分析比较了成年患者各种动脉置管方法的成功率，发现现有数据存在异质性。因此，我们开展了这项研究，以评估并比较触诊法与超声引导下桡动脉置管法的成功率。目的是比较触诊法与超声引导下桡动脉置管技术（即短轴平面外法和长轴平面内法）的首次尝试成功率。
方法
这是一项前瞻性、随机、平行组研究。90例年龄在18至50岁之间（因各种手术需要进行桡动脉置管以监测有创血压或频繁进行动脉血气分析）的患者被分为3组。每组采用3种桡动脉置管技术中的一种，即触诊法、短轴超声法和长轴超声法。分析的参数包括首次尝试成功率、所需尝试次数、置管时间、技术交叉需求以及并发症发生率。采用单向方差分析和Tukey事后检验进行多变量分析。对于分类数据，使用卡方检验。概率值0.05被视为显著水平。
结果
长轴法的首次尝试成功率为76.7%，短轴法为86.7%，触诊法为56.7%。短轴法已被证明置管时间更短，成功置管所需尝试次数更少，且在前两次尝试失败时技术交叉需求更低。
结论
我们得出结论，与传统触诊法相比，超声引导下的桡动脉短轴置管法首次尝试成功率更高。
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