不同方式B超指导下深静脉置管在急诊科中的应用

Application of deep vein catheterization under the guidance of different B-ultrasound in emergency department

目的分析不同方式B超指导下深静脉置管在急诊科中的应用。方法 140例行B超指导下深静脉置管的患者,根据B超指导深静脉置管方式不同分为对照组与观察组,各70例。对照组采用B超静态指导深静脉置管,观察组采用B超动态引导深静脉置管。比较两组股静脉置管患者、颈内静脉置管患者、锁骨下静脉置管患者穿刺情况及深静脉置管综合穿刺情况。结果观察组股静脉置管患者首次穿刺成功率及置管完成时间分别为100.00%、(3.5±0.3)min,均优于对照组的73.08%、(6.3±0.4)min,差异均具有统计学意义(P<0.05)。观察组颈内静脉置管患者首次穿刺成功率、穿刺总成功率及置管完成时间分别为96.15%、100.00%、(3.2±0.7)min,均优于对照组的70.83%、79.17%、(7.4±0.6)min,差异均具有统计学意义(P<0.05)。观察组锁骨下静脉置管患者首次穿刺成功率、穿刺总成功率及置管完成时间分别为86.96%、95.65%、(4.6±0.3)min,均优于对照组的60.00%、70.00%、(8.1±0.2)min,差异均具有统计学意义(P<0.05)。观察组深静脉置管患者首次穿刺成功率、穿刺总成功率及置管完成时间分别为94.29%、98.57%、(3.8±0.5)min,均优于对照组的68.57%、81.43%、(7.2±0.1)min,差异均具有统计学意义(P<0.05)。结论急诊科行B超动态引导下深静脉置管可以提高穿刺成功率,缩短置管时间,有利于迅速开通急危重症患者的深静脉通路。

Objective To analyze the application of deep vein catheterization under the guidance of different B-ultrasound in emergency department. Methods A total of 140 patients with deep vein catheterization under the guidance of different B-ultrasound were divided into control group and observation group according to the different ways of deep vein catheterization guided by B-ultrasound, with 70 cases in each group. The control group received deep venous catheterization guided by static B-ultrasound, and the observation group received deep venous catheterization guided by dynamic B-ultrasound. The puncture conditions of patients with femoral vein catheterization, internal jugular vein catheterization, subclavian vein catheterization, and comprehensive puncture conditions of patients with deep vein catheterization were compared between the two groups. Results In femoral vein catheterization patients, the success rate of first puncture and completion time of catheterization of the observation group were 100.00% and(3.5±0.3) min, which were better than 73.08% and(6.3±0.4) min of the control group, and the difference was statistically significant(P<0.05). In internal jugular vein catheterization patients, the success rate of first puncture total success rate of puncture and completion time of catheterization of the observation group were 96.15%, 100.00% and(3.2±0.7) min, which were 70.83%, 79.17% and(7.4± 0.6) min of the control group, and the difference was statistically significant(P<0.05). In subclavian vein catheterization patients, the success rate of first puncture total success rate of puncture and completion time of catheterization of the observation group were 86.96%, 95.65% and(4.6±0.3) min, which were better than 60.00%, 70.00% and(8.1±0.2) min of the control group, and the difference was statistically significant(P<0.05). In deep vein catheterization patients, the success rate of first puncture total success rate of puncture and completion time of catheterization of the observation group were 94.29%, 98.57% and(3.8±0.5) min, which were better than 68.57%, 81.43% and(7.2±0.1) min of the control group, and the difference was statistically significant(P<0.05). Conclusion The catheterization of deep vein under the dynamic guidance of B-ultrasound in emergency department can improve the success rate of puncture, shorten the catheterization time, and facilitate the rapid opening of deep vein access for critical patients.