超声引导与触诊盲探法用于成人足背动脉穿刺置管的随机对照研究

Ultrasound Guided Dorsal Pedal Artery Cannulation vs Palpation Technique in Adult:a Randomized Controlled Trial

目的比较超声引导足背动脉穿刺置管与触诊盲探穿刺置管的操作时间、首次穿刺成功率、穿刺次数、成功率和并发症发生率。方法选取80例本院2016年6月至2016年11月住院,年龄18~60岁,ASA分级Ⅱ~Ⅲ级,神经外科择期手术需足背动脉穿刺置管的患者,按随机数字表法分为超声引导足背动脉穿刺组(U组)和触诊盲探穿刺组(P组),每组40例。穿刺前记录年龄、性别、身高、体重、无创血压和心率等一般信息。然后记录操作时间、穿刺次数、首次穿刺成功率和总体成功率、穿刺相关并发症发生率等参数。结果两组患者的年龄、性别、体重指数、穿刺前的平均血压和心率等基本参数差异无统计学意义(P>0.05)。虽然两组总体穿刺成功率和穿刺相关并发症比较,差异无统计学意义(P>0.05),但U组首次穿刺成功率(75%,95%CI 65.51%~84.48%)显著高于P组(50%,95%CI 39.04%~60.96%),且U组操作时间(35.5±8.6)s显著少于P组(50.2±22.5)s,差异有统计学意义(P<0.01)。结论与传统触诊盲探法相比,超声引导足背动脉穿刺置管可以缩短操作时间、减少穿刺次数、提高首次穿刺成功率,而不增加并发症发生率。

Objective To evaluate the operation time,first puncture success rate,success rate and complication rate of ultrasound guided dorsal pedal artery cannulation compared with that of palpation technique.Methods A total of 80 participants hospitalized from June 1,2016 to November,2016,aged 18 to 60 years old,ASA grade II to III were divided into ultrasound-guided dorsal foot artery puncture group(group U)and palpation-blind puncture group(group P)by the random number table method,with 40 patients in each group.They all require back foot artery puncture and catheterization for elective neurosurgery surgery.Before cannulation,the information of age,sex,weight,height,none invasive blood pressure and heart rate were recorded.Then,time consumption,number of attempts,success rate of first attempt,success rate and complications were recorded.Results There were no significant statistic differences between the two groups regarding age,sex,weight,mean blood pressure and heart rate(P>0.05),and there were no significant statistic differences between the two groups regarding common success rate and incidence of complications(P>0.05).However,the success rate of first attempt in Group U(75%,95%CI 65.51%~84.48%)was significantly higher than that in Group P(50%,95%CI 39.04%~60.96%).The operating time of group U(35.5±18.6)s was significantly less than that of group P(50.2±22.5)s(P<0.01).Conclusion Dorsal pedal artery cannulation guided by ultrasound may improve the success rate of first attempt,decrease number of attempts and time consumption when compared with cannulation guided by traditional palpation technique without increasing the complication rate.