超声定位与超声引导对血透患者穿刺效果及透析血流速的影响效果比较

Investigate the Puncture Effect of Ultrasonography and Ultrasound Guidance on Hemodialysis Patients

目的:探讨超声定位与超声引导对血液透析患者的穿刺效果、导管留置时间和对穿刺血管血流动力学的比较。方法:纳入2015年—2017年四川省林业中心医院行右侧颈内静脉置管穿刺进行血液透析的患者共70例,依据穿刺置管方法的不同,将患者分为观察组(n=36)和对照组(n=34),其中观察组患者行超声定位法,对照组患者行超声引导法,两组患者术前均行超声检查,比较两组患者在置管时间、穿刺成功率、穿刺并发症、病人满意度、导管留置时间以及穿刺血管的血液动力学等差异。结果:观察组患者总穿刺时间少于对照组,差异有统计学意义(P<0.05);观察组一次成功率及患者满意度与对照组比较差异均无统计学意义(P>0.05);观察组患者血透平均血流速和导管留置时间均显著高于对照组,差异有统计学意义(P<0.05)。结论:超声定位较超声引导具有穿刺时间少、透析血流速高,且一次成功率、穿刺并发症、病人满意度等不劣于对照组优点。

Objective： To investigate the puncture effect of ultrasonography and ultrasound guidance on hemodialysis patients and the comparison of the perforating vessel hemodynamics. Methods： A total of 70 patients undergoing hemodialysis were enrolled from 2015 to 2017. The patients were randomly divided into observation group and control group according to random number method. Ultrasonography was performed before surgery in both groups. The differences of catheterization time, puncture success rate, puncture complication and patient satisfaction, and hemodynamic parameters of puncture vessels were compared between the two groups. Results： The total puncture time in observation group was less than that in control group（P〈0.05）. There was no significant difference in success rate between the two groups at one time（P〉0.05）. The mean hemodialysis blood flow velocity was significantly different between the two groups（P〈0.05）. Conclusion： Compared with ultrasound guidance, ultrasound localization has the advantages of less puncture time, higher dialysis blood flow velocity, success rate, puncture complication and patient satisfaction than the control group.