胫后动脉穿刺采血法在新生儿科的应用

Application of posterior tibial artery puncture for blood sampling in the department of pedatrics

目的探索胫后动脉穿刺采血法在新生儿科的应用。方法对新生儿科收治疗的450例新生儿随机分为胫后动脉组（A组）、桡动脉（B组）及股动脉（c组）各150例。对三组采血方法中穿刺点青紫范围、血肿发生率及一次穿刺成功率进行对比。结果A组青紫范围半径〈0．2em的有79例，占52％；发生血肿的有5例，占3_3％；1次穿刺成功的有136例，占90．6％。B组青紫范围半径〈0．2em的有66例，占44％；发生血肿有11例，占7．3％；一次穿刺成功有114例，占76．0％．C组青紫范围半径〈0．2cm的有53例，占35％；发生血肿有30例，占20％；一次穿刺成功有82例，占54．6％。结论经胫后动脉采血技术，成功率较高，可操作性强，比桡动脉、股动脉采血时对患者的不良影响要小，易掌握，且能提供多一个采血部位，减轻患儿痛苦，值得在工作中推广。

Objective To explore the application of posterior tibia1 artery puncture for blood sampling in the department of pedatrics. Methods 450 neonates who had been treated in the neonatal department were randomly divided into posterior tibial artery group （group A）, radial artery group （group B）, and femoral artery group （group C）, 150 for each group. The cyanoderma area of the puncture point, and the rate of hematoma, and the success rate of primary puncture were compared among the three groups. Results In group A, 79 （52%） patients had a diameter of cyanoderma less than 2 cm; 5 （3.3%） developed hematoma; and 136 （90.6%） had a success rate of primary puncture. In group B, 66 （44%） patients had a diameter of cyanoderma less than 2 cm; 11 （7.3%） developed hematoma; and 114 （76.0%） had a success rate of primary puncture. In group C, 53 （35%） patients had a diameter of cyanoderma less than 2 cm; 30 （20%） developed hematoma; and 82 （54.6%） had a success rate of primary puncture. Conclusions Posterior tibial artery puncture for blood sampling has a higher success rate and is easier to control. It has fewer adverse effects than radial artery or femoral artery puncture and provides additional blood sampling site, which can relieve pain in neonatal patients. It is worth popularizing clinically.