超声引导下动态针尖定位法在桡动脉穿刺置管中的应用

Application of ultrasound-guided dynamic needle tip positioning in radial artery puncture

目的探讨超声引导下动态针尖定位法(DNTP)在桡动脉穿刺置管中的应用。方法选取2022年3月至2023年10月在黔南布依族苖族自治州人民医院麻醉科行择期手术需行桡动脉穿刺的80例患者作为研究对象,采用随机数字表法将符合标准的患者分为超声引导直入法(UGDN)组(n=40)和DNTP组(n=40)。比较两组的桡动脉穿刺置管的无血肿首次置管成功例数、首次穿刺成功例数、穿刺次数、穿刺时间、动脉后壁损伤例数和血肿发生例数。结果DNTP组无血肿首次置管成功率高于UGDE组,差异有统计学意义(P<0.05);DNTP组穿刺次数少于UGDE组,差异有统计学意义(P<0.05);DNTP组穿刺时间长于UGDE组,差异有统计学意义(P<0.05);DNTP组动脉后壁损伤例数、血肿发生率低于UGDE组,差异有统计学意义(P<0.05);两组的首次穿刺成功率比较,差异无统计学意义(P>0.05)。结论超声引导下DNTP应用于桡动脉穿刺置管中,虽然延长了穿刺时间,但是提高了置管成功率,减少了穿刺次数,降低了穿刺并发症发生率,是一种安全有效的方法。

Objective To explore the application of dynamic needle tip positioning(DNTP)under ultrasonic guidance in radial artery puncture.Methods Eighty patients in the People's Hospital of Qiannan Buyi and Miao Autonomous Prefecture who need radial artery puncture for elective anesthesia surgery from March 2022 to October 2023 were selected as the research objects.Under random number table method,the patients who met the criteria were divided into ultrasound guided direct entry(UGDE)group(n=40)and DNTP group(n=40),the UGDE group was performed with ultrasound-guided direct insertion method,and the DNTP group was adopted ultrasound guided dynamic needle point positioning legal position method.The number of successful first catheterization without hematoma,the number of successful first puncture,the number of puncture times,puncture time,the number of posterior artery wall injury and the number of hematoma were compared between the two groups.Results The rate of successful cases without hematoma in DNTP group was higher than that in UGDE group,the difference was statistically significant(P<0.05).The puncture times of DNTP group was less than UGDE group,the difference was statistically significant(P<0.05).Puncture time in DNTP group was longer than UGDE group,the difference was statistically significant(P<0.05).The rates of posterior artery wall injury and hematoma in DNTP group were lower than those in UGDE group,the differences were statistically significant(P<0.05).There was no significant difference in comparing the number of successful first puncture cases between the two groups(P>0.05).Conclusion The application of ultrasound guided DNTP in radial artery catheterization prolongs the puncture time,but improves the success rate of catheterization,reduces the number of puncture times and reduces the incidence rate of puncture complications.It is a safe and effective method.