改良穿刺角度在老年重症患者桡动脉置管中的应用

Application of modified puncture angle on radial arterial cannulation for critically elderly patients

目的观察改良穿刺角度在老年重症患者桡动脉置管中的应用效果。方法将125例行桡动脉穿刺置管的老年重症患者按随机数字表分为观察组58例与对照组67例,观察组穿刺桡动脉时,穿刺针与皮肤成90°执笔式垂直进针,见动脉回血后压低穿刺针与皮肤成15~30°进针0.5~1cm,然后再压低至紧贴皮肤将穿刺针送入血管后以旋转方式送入导管;对照组采用传统方法置管,比较两种方法置管的成功率和局部渗血发生率。结果观察组置管成功率高于对照组,局部渗血发生率低于对照组,比较差异均有统计学意义(P<0.05)。结论改良穿刺角度置管方法可提高老年重症患者桡动脉置管的成功率。

Objective To observe the application effect of modified puncture angle on radial arterial cannulation for critically elderly patients.Method Divide 125 critically elderly patients undergoing radial arterial cannulation into observation group（n=58）and control group（n=67）by random number table.Patients in observation group receive radial arterial cannulation at the angle of 90°between puncture needle and skin.Lower the angle to 15~30°after artery blood return and insert the needle for 0.5~1 cm.Then lower the puncture needle to skin,insert the needle into artery and insert the catheter by rotation.Patients in observation group receive radial arterial cannulation by routine method.Compare the success rate of catheter insertion and incidence of local blood oozing between two groups.Result Observation group has higher success rate of catheter insertion and lower incidence of local blood oozing than control group.The difference is significant（P0.05）.Conclusion Methods of inserting catheter by modified puncture angle can improve the success rate of catheter insertion for critically elderly patients.