穿刺针扩皮法在B超引导下中等长度导管置管中的应用

Application of the skin incision method using puncture needle in ultrasound-guided placement of midline catheters

目的观察穿刺针扩皮法在B超引导下中等长度导管置管中的应用效果。方法将160例接受中等长度导管置管的患者分为研究组80例和对照组80例。研究组在B超引导下用血管穿刺针穿刺成功置入导丝后,用导管包内16G穿刺针套在导丝外,沿导丝送入至针头斜面后退出穿刺针。对照组在成功置入导丝后,用手术刀在穿刺点上方沿导丝方向作1个3mm竖形切口。比较2组患者置管后渗血、输液不畅、导管滑脱的发生情况。结果研究组和对照组置管后渗血发生率分别为23.75%(19/80)和38.75%(31/80),差异有统计学意义(P<0.05)。2组输液不畅和导管滑脱发生率差异无统计学意义(P>0.05)。结论穿刺针扩皮法应用于B超引导下的中等长度导管置管,能有效减少置管后渗血的发生风险。

Objective To evaluate the skin incision method using puncture needle in ultrasound-guided placement of midline catheters.Methods Totally 160 patients undergoing ultrasound-guided placement of midline catheter were divided into the study group and the control group,with 80 cases in each group.In the study group,the guide wire was inserted through a 21-G needle under the guide of B-ultrasound.After the puncture needle withdrawal,a 16-G puncture needle guard was sleeved outside the guide wire,and was removed after the guide wire was sent to the inclined surface of the needle.In the control group,a 3 mm vertical incision was made with the scalpel in the direction of the guide wire at the puncture point after the guide wire was successfully placed.The incidence of hemorrhage,unsmooth liquid infusion and catheter slippage were compared between the two groups.Results The incidence of hemorrhage after catheterization in the study group was less than that of the control group(23.75%%vs 38.75%,P<0.05).There was no significant difference in the incidence of unsmooth liquid infusion and catheter slippage between two groups(P>0.05).Conclusion The application of the skin incision method using puncture needle can effectively reduce the incidence of hemorrhage after ultrasound-guided placement of midline catheters.