体表坐标法在采集动脉血标本中的应用

目的比较血气传统采血方法与利用桡腕关节最高点、趾跖关节最高点为体表坐标采集动脉血的成功率。方法将2007年8月～2008年2月收治的心胸外科疾病术后进入ICU监护治疗的180例患者随机分为两组:一组从桡动脉采血81例,并随机分为对照A组(传统采血法)41例和观察B组(利用体表坐标采血法)40例;另一组从足背动脉采血99例,并随机分为对照C组(传统采血法)49例和观察D组(利用体表坐标采血法)50例。比较传统采血法与利用体表坐标采血法的成功率。结果桡动脉A、B两组采集动脉血成功率分别为75.6%与95.0%,两组比较,P<0.05,差异有统计学意义;足背动脉采血C、D两组采集动脉血成功率分别为81.6%与96.0%,两组比较,P<0.05,差异有统计学意义。结论利用桡腕关节最高点、趾跖关节最高点为体表坐标法采集动脉血标本,能缩短操作时间,定位误差在最低限度,提高了穿刺成功率,值得临床推广应用。

Objective To explore the feasibility of collecting arterial blood with the coordinate method at body surface by way of comparing the success rates of collecting blood with conventional method of blood air analysis and with the coordinate method of using apogee of antibrachio-carpal joint and digit-metatarsal joint. Methods 180 patients eared at ICU after operation from August 2007 to February 2008 were divided into two groups. The 81 cases in one group, with arterial blood collected from the radial artery, were sub-divided into control group （group A with 41cases） and observation group （group B with 40 cases）. The 99 cases in another group, with artery blood collected from arteria dorsalis pedis, were sub-divided into control group （group C with 49 cases） and observation group （group D with 50 cases）. The success rates of the four sub-groups having arterial blood collected with the conventional method and with the coordinate method of collecting blood from radial artery and arteria dorsalis pedis at body surface. Results The success rates in arterial blood collection from radial artery in group A and group B were 75.6% and 95.0%, respectively, with significant difference （P 〈 0.05） and those in arterial blood collection from arteria dorsalis pedis in group C and group D were 81.6% and 96.0%, respectively, with significant difference （P 〈 0.05）. Conclusion Arterial blood collection by the coordinate method in body surface using apogee of antibrachio-carpal joint and digit-metatarsal joint can shorten operating duration, reduce the location error to the lowest level, and improve success rate of puncturing. It is worth popularizing clinically.