高频线阵超声辅助定位在解剖标志定位困难病人蛛网膜下腔穿刺中的应用分析

High frequency linear array of ultrasound assisted localization is helpful to improve the success rate of subarachnoid puncture in patients with difficulty in locating anatomical landmarks

目的 探讨穿刺前应用高频线阵超声辅助定位能否提高解剖标志定位困难病人蛛网膜下腔麻醉的穿刺成功率。方法 采用前瞻性随机对照的方法,将110例拟行下肢手术、解剖标志定位困难的病人分为传统解剖定位组和高频线阵超声定位组,每组各55例。主要观察指标包括一次穿刺成功率。次要观察指标包括分别记录L2-3与L3-4解剖定位与高频线阵超声定位穿刺点之间相差的距离,穿刺角度,穿刺次数等。结果 解剖组一次穿刺成功率为26.53%,高频线阵超声组一次穿刺成功率为61.11%,两组比较差异有统计学意义(P<0.05)。结论 应用高频线阵探头超声辅助定位对拟行蛛网膜下腔麻醉解剖定位困难的病人进行穿刺前定位,可以提高一次穿刺成功率,减少穿刺次数。

Objective To explore whether the application of high frequency linear array ultrasound assisted localization before puncture can improve the success rate of subarachnoid anesthesia in patients with difficulty in locating anatomical landmarks.Methods A randomized controlled trial was used to localize the anatomic landmarks.110 cases of patients who could not be touched the spinous process clearly were divided into two groups: the traditional anatomical positioning group(Group J) and the ultrasound assisted group(Group C),each group were 55 cases.The main outcome include the success rate of one-time puncture.Secondary outcome include the distance, puncture angle and puncture times between anatomical and ultrasound localization of L2-3 and L3-4.Results The success rate of one-time puncture was 26.53% in anatomy group and 61.11% in ultrasound group, the difference was statistically significant(P<0.05).Conclusion The application of high-frequency linear array probe ultrasound assisted localization in patients with difficulty in anatomic localization of subarachnoid anesthesia can effectively improve the success rate of one-time puncture and reduce the times of puncture.