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优化重症监护病房动脉穿刺的精准度:超声引导下动态针尖定位的影响

Optimizing precision in ICU arterial access: the impact of ultrasound-guided dynamic needle tip positioning.

作者信息

Chen Xiuqin, Wu Yongrui, Zhang Li, Zhou Ying, Fang Hui

机构信息

Intensive Care Unit, Taihe County People's Hospital, Fuyang, Anhui, China.

Medical School, Fuyang Normal University, Fuyang, Anhui, China.

出版信息

Front Med (Lausanne). 2025 Jul 31;12:1625108. doi: 10.3389/fmed.2025.1625108. eCollection 2025.

Abstract

OBJECTIVE

This study aims to evaluate the efficacy of ultrasound-guided dynamic needle tip positioning (DNTP) in arterial puncture and catheterization among ICU patients.

METHODS

A cohort of 55 patients in shock, requiring arterial catheterization in the ICU from April 2020 to July 2024, was enrolled and randomly stratified into groups based on distinct ultrasound-guided puncture techniques. Of these, 27 patients who underwent the ultrasound-guided direct entry (UGDE) method were designated as the control group, while 28 patients who received arterial catheterization via the ultrasound-guided DNTP technique were assigned to the observation group. Comparative analyses were conducted on the first-attempt puncture success rate, first-attempt catheterization success rate, puncture duration, and incidence of puncture-related complications between the two groups.

RESULTS

The first-attempt puncture success rate did not significantly differ between the observation and control groups ( = 0.98). However, the observation group exhibited a higher first-attempt catheterization success rate ( = 0.049), an extended puncture duration ( < 0.001), and a reduced overall incidence of puncture-related complications ( = 0.049) in comparison to the control group.

CONCLUSION

The application of ultrasound-guided DNTP methodology demonstrates statistically significant improvement in arterial catheterization procedural success rates concurrent with a marked reduction in iatrogenic vascular access complications.

摘要

目的

本研究旨在评估超声引导下动态针尖定位(DNTP)在重症监护病房(ICU)患者动脉穿刺置管中的有效性。

方法

纳入2020年4月至2024年7月在ICU需要进行动脉置管的55例休克患者,并根据不同的超声引导穿刺技术将其随机分层分组。其中,27例行超声引导直接进针(UGDE)法的患者被指定为对照组,28例接受超声引导DNTP技术进行动脉置管的患者被分配到观察组。对两组的首次穿刺成功率、首次置管成功率、穿刺时间以及穿刺相关并发症的发生率进行比较分析。

结果

观察组和对照组的首次穿刺成功率无显著差异(=0.98)。然而,与对照组相比,观察组的首次置管成功率更高(=0.049),穿刺时间更长(<0.001),穿刺相关并发症的总发生率更低(=0.049)。

结论

超声引导DNTP方法的应用在动脉置管手术成功率方面显示出统计学上的显著提高,同时医源性血管通路并发症显著减少。

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