超声引导下右颈内静脉穿刺置管在血液透析中的应用价值

The Application Effects of Ultrasound-guided Right Internal Jugular Vein Puncture in the Hematodialysis

目的:探讨超声引导下右颈内静脉穿刺置管在血液透析中的应用价值。方法:选取本院2012年2月-2014年2月收治的240例需行右颈内静脉穿刺置管进行血液透析的患者作为研究对象,使用随机数字表法将其分为研究组和对照组,每组各120例。对照组患者采用传统盲穿置管,研究组患者采用超声定位引导进行穿刺置管,对比两组患者的置管穿刺成功率、穿刺时间、患者满意度及并发症情况。结果:(1)研究组一次成功率(87.50%)、总成功率(100%)及患者满意度(84.17%)均明显高于对照组的一次成功率(75.00%)、总成功率(90.00%)及患者满意度(70.83%),差异均有统计学意义(P<0.05);(2)研究组患者穿刺置管的平均时间为(29±8)s,明显低于对照组的(66±12)s,差异有统计学意义(P<0.05);(3)研究组患者穿刺置管过程中并发症的发生率为0.83%,明显低于对照组的10.83%,差异有统计学意义(P<0.05)。结论:在超声引导下右颈内静脉穿刺置管进行血液透析可以明显缩短穿刺时间,提高穿刺成功率,降低并发症的发生率,提高患者的满意度,故值得在临床上进一步推广。

Objective： To analyze the application effects of ultrasound-guided right internal jugular vein puncture in the hematodialysis.Method： 240 patients who should conduct the hematodialysis through the ultrasound-guided right internal jugular vein puncture and who accepted treatment in our hospital from February 2012 to February 2014 were taken as the research objects, and these patients were randomly divided into the control group and the observation group with a list of random numbers, with 120 patients in each group.In the control group, they were treated with the traditional blind wear catheter while in the observation group, they were treated with the ultrasound-guided right internal jugular vein puncture. Then, the success rate of catheter puncture, the time of puncture, the satisfaction degree of patients and the occurrence of complications of these two groups of patients were analyzed and compared.Result：（1）In the observation group, the one-time success rate of catheter puncture was 87.50%, the whole success rate was 100% and the satisfaction degree of patients was 84.17%, which was evidently higher than one-time success rate of catheter puncture （75.00%）, the whole success rate 90.00%） and the satisfaction degree of patients （70.83%） in the control group, the differences had statistical significance（P〈0.05）.（2） The average time of catheterization of patients in the observation group was （29±8）s, which was evidently lower than that of （66±12）s in the control group and the differences had statistical significance（P〈0.05）.（3） In the observation group, the occurrence rate of complications in the process of catheterization was 0.83%, which was evidently lower than that of 10.83% in the control group and the differences had statistical significance （P〈0.05）.Conclusion： The ultrasound-guided right internal jugular vein puncture in the hematodialysis can evidently shorten the puncture time, improve the success rate of puncture, decrease the occurrence rate of complications, and improve the satisfaction degree of patients. Thus, it should be promoted in the clinical applications.