超声定位法在腋静脉穿刺中的安全性评价
Safety evaluation of ultrasound location in axillary venipuncture
目的 探讨超声定位法同体表定位(Magney)法腋静脉穿刺置管的成功率和安全性.方法 选取 2017年 1月至 2018年 9月本院 EICU患者,共纳入患者 80例,随机(随机数字法)分为 Magney法(n=35)和超声引导法(n=45).统计穿刺成功次数、成功率和并发症情况.结果 Magney定位法同超声定位法比较,1次成功率(25.7%vs 68.9%,P < 0.01)、穿刺大于 2次(34.3%vs 11.1%,P=0.012)及总成功率(82.9%vs 100%,P=0.004),差异有统计学意义.两种穿刺方法均有误穿动脉,差异无统计学意义.Magney定位法发生血肿 2例,臂丛神经损伤 1 例,48 h内未发生感染;超声定位法未发生并发症.结论 超声定位法腋静脉穿刺是一种安全有效的中心静脉置管方法,较体表定位(Magney)法有更高的成功率和安全性.
更多Objective To explore the success rate and safety of axillary venipuncture catheterization with ultrasound localization and homologous surface localization(Magney).Method A total of 80 patients were enrolled in the EICU from January 2017 to September 2018.They were randomly assigned to the Magney method(n=35)and the ultrasound-guided method(n=45).The number of successful punctures,success rate and complications were recorded.Results Compared with ultrasound-guided method,the one-time success rate(25.7%vs 68.9%,P<0.01),puncture greater than 2 times(34.3%vs 11.1%,P=0.012),and total success rate(82.9%vs 100%,P=0.004)in Magney method were significantly different.Both of the two puncture methods were mis-invasive,and the difference was not statistically significant.In Magney method 2 patients occurred hematoma and 1 patient brachial plexus injury,but no infection occurred within 48 h.While no such occurrence was found in ultrasound-guided method.Conclusion Ultrasound-guided method axillary venipuncture is a safe and effective method of central venous catheterization,which has higher success rate and safety than Magney method.
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