腋静脉置管中实时超声引导与体表标志方法的比较

A comparison of real-time ultrasound-guided and landmark approaches to axillary vein cannulation

目的比较实时超声引导与体表标志两种方法在腋静脉置管中的优劣。方法回顾性分析2015年5月至2015年11月于本院接受腋静脉置管的228例患者的临床资料,其中,实时超声引导置管126例(超声组),体表标志法置管102例(体表标志组)。记录两组术中操作时间、一次试穿成功率及术后并发症发生情况。所有患者置管后均拍摄X线胸片以确认有无气胸发生。结果超声组一次试穿成功率显著高于体表标志组(92%︰80%,P<0.01)。超声组术中操作时间短于体表标志组[(6.63±0.66)分钟︰(9.26±1.05)分钟,P<0.01],术后并发症少。结论实时超声引导下腋静脉置管可提高一次试穿成功率,明显缩短操作时间,减少并发症,提高了腋静脉置管的安全性。

Objective To investigate the clinical effect of real-time ultrasound-guided and landmark approaches axillary vein catheterization. Method Retrospectively analyzed the data of 228 adult patients who required axillary vein catheterization from May 2015 to November 2015 in our hospital. All the patients were randomly divided into ultrasound group（n = 126） and landmark-guided group（n = 102）. The operation time, one-attempt success rate and postoperative complications were compared between the two groups. All patients were taken chest X-ray film to confirm the existence of pneumothorax. Result The one-attempt success rate of ultrasound group was significantly higher than landmark group（92% ︰ 80%, P〈0.01）. Ultrasound group had shorter operation time than landmark group [（6.63±0.66） minutes ︰（9.26±1.05） minutes, P〈0.01]. Also, ultrasound group had lower incidence of postoperative complications than landmark group（P〈0.05）. Conclusion Real-time ultrasound-guided axillary vein catheterization has a higher one-attempt success rate, shorter operation time and lower incidence rate of postoperative complications and could improve the safety of axillary vein catheterization.