Mao Yuanhong, Huang Xiaomei, Yang Hong, Zhou Shu, Yuan Aihong, Lin Gang, Geng Guiling
Medical Imaging Department, Nantong First People's Hospital, Jiangsu, China.
Radiotherapy Department, Nantong First People's Hospital, Jiangsu, China.
Appl Bionics Biomech. 2022 May 14;2022:9384983. doi: 10.1155/2022/9384983. eCollection 2022.
This study evaluated the impact of a novel venipuncture method on vascular parameters of vena basilica to provide a new technical option for the clinical management of difficult venipuncture.
32 volunteers examined by ultrasound at the Medical Imaging Center of The First People's Hospital of Nantong, Jiangsu province, from February 2020 to April 2020 were randomly selected. One hand of each patient was ligated with the traditional single tourniquet and the new ligation method for 20 seconds. Then, the distance between the left or right vena basilica and the skin and the diameter of blood vessels were measured by ultrasound. 98 patients with peripheral venipuncture difficulty who were examined by ultrasound of a third-grade hospital from April 2019 to March 2020 were selected and randomly divided into control group ( = 49) and experimental group ( = 49). The traditional method was used in the control group, and the new peripheral venipuncture was used in the experimental group. The success rate of single puncture, preparation time before puncture, time required for puncture operation, pain reaction during puncture, intravascular congestion after puncture, subcutaneous tissue injury, and vascular reuse rate after puncture were compared between the two methods.
The new ligation and puncture method increased the diameter of peripheral superficial vein vessels by 0.51 ± 0.04 mm, and the change of vena basilica diameter was not significantly associated with gender and age of patient. The success rate of single puncture and the vascular reuse rate were significantly higher in the experimental group than in the control group, while the preparation time and venipuncture time, as well as the patient's pain response, were significantly lower in the experimental group compared to the control group, and the intravascular congestion and subcutaneous tissue injury were lower. In addition, the mean satisfaction score of patients in the experimental group was higher than that of the control group.
The new ligation and puncture method was an effective vena basilica dilation technique for filling the peripheral superficial veins, improving puncture success rate of peripheral difficult vein, and reducing patient pain, which was worth popularizing and applying in clinic.
本研究评估一种新型静脉穿刺方法对贵要静脉血管参数的影响，为临床处理困难静脉穿刺提供一种新的技术选择。
随机选取2020年2月至2020年4月在江苏省南通市第一人民医院医学影像中心接受超声检查的32名志愿者。每位患者的一只手分别用传统单止血带和新的结扎方法结扎20秒。然后，用超声测量左右贵要静脉与皮肤之间的距离以及血管直径。选取2019年4月至2020年3月在某三级医院接受超声检查的98例外周静脉穿刺困难患者，随机分为对照组（n = 49）和试验组（n = 49）。对照组采用传统方法，试验组采用新型外周静脉穿刺方法。比较两种方法的单次穿刺成功率、穿刺前准备时间、穿刺操作所需时间、穿刺时的疼痛反应、穿刺后血管内淤血、皮下组织损伤以及穿刺后血管复用率。
新的结扎穿刺方法使外周浅静脉血管直径增加了0.51±0.04 mm，贵要静脉直径的变化与患者的性别和年龄无显著相关性。试验组的单次穿刺成功率和血管复用率显著高于对照组，而试验组的准备时间和静脉穿刺时间以及患者的疼痛反应均显著低于对照组，且血管内淤血和皮下组织损伤较少。此外，试验组患者的平均满意度评分高于对照组。
新的结扎穿刺方法是一种有效的贵要静脉扩张技术，可充盈外周浅静脉，提高外周困难静脉穿刺成功率，减轻患者疼痛，值得在临床推广应用。
