小儿大隐静脉留置针穿刺方法的改进

Improvement of puncture method of vein indwelling needle on great saphenous

目的：探讨提高小儿大隐静脉留置针穿刺成功的方法。方法选取住院患儿200例,随机分为对照组和观察组,对大隐静脉进行静脉留置针穿刺。对照组采用传统穿刺法,选择内踝下方的大隐静脉可见部分或可触摸部分的最低点为穿刺点,以15~30°角为进针角度；观察组选择内踝上方大隐静脉最凸显部位或能触摸到的最凸处为穿刺点,以≥45°角进针；比较2组穿刺后首次见回血和第2、3次见回血情况及穿刺成功情况。结果2组首次见回血情况比较,差异无统计学意义（χ^2=0.479,P〉0.05）；但第2、3次见回血及穿刺成功情况比较,观察组明显高于对照组（χ^2=24.381,P〈0.01；χ^2=30.645,P〈0.01）。结论小儿大隐静脉留置针采用大隐静脉最凸显部位或能触摸的最凸处为穿刺点,并以≥45°角进行穿刺,穿刺成功率高。

Objective To explore the method to raise success rate of indwelling needle puncture on great saphenous vein in children.Methods Totally 200 hospitalized children were randomly divided into observation group and control group. All of the children were given indwelling needle puncture on great saphenous vein.In the observation group,the most prominent site of great saphenous vein in the superior medial malleolus or the most protruding site that could be touched was selected as the puncture point,and the puncture angle was not less than 45°.While in the control group,visible site of great saphenous vein in the inferior medial malleolus or the most pitting site that could be touched was selected as the puncture point,and the puncture angle was 1 5 to 30°.The first time,the second and third time to see the blood returning and puncture success rate of 2 groups were compared.Results The first time to see the blood returning in 2 groups had no statistical difference（χ^2=0.479,P〉0.05）,but the cases of the second and third time to see the blood returning and the puncture success in the observation group was significantly more than that in the control group（χ2 =24.381,χ^2 =30.645,P〈0.01）.Conclusion Success rate of indwelling needle puncture of great saphenous vein in children is higher with the most prominent site or the most protruding site that can be touched as the puncture point and the puncture angle was not less than 4 5°.