改良桡动脉置管术在ICU患者中的应用效果研究

Application of modified radial artery catheterization in ICU patients

目的探究超声引导下于桡骨茎突近心端4~5cm处留置动脉导管在ICU患者中的应用效果。方法采用便利抽样法,选择湖北省某三级甲等医院ICU2020年8月-2021年7月收治的82例患者为研究对象,根据入组时间顺序分为两组。试验组41例于桡骨茎突近心端4~5cm的位置,在超声引导下实施穿刺置管;对照组41例在桡骨茎突内侧0.5cm动脉搏动最强处实施触摸盲穿法置管。比较两组桡动脉置管一次穿刺成功率、留置导管时间,以及穿刺点渗血、肿胀、导管打折、导管堵塞拔管等发生率。结果试验组一次穿刺成功率达95.12%,导管留置时间为(151.49±14.41)h,与对照组相比,差异具有统计学意义(P<0.05);留置导管穿刺点渗血(4.87%)、导管打折(4.87%)、导管堵塞拔管(0)发生率均低于对照组(P<0.05)。结论超声引导下于桡骨茎突近心端4~5 cm处动脉置管,有助于提高一次性穿刺成功率,延长动脉导管留置时间,并降低穿刺点渗血等发生率。

Objective To explore the application effect of indwelling arterial catheter 4~5 cm near the cardiac end of radial styloid process under ultrasound guidance in ICU patients.Methods 82 critically ill patients in ICU of a tertiary class A hospital in Hubei Province from August 2020 to July 2021 wereselected as theresearch objects by convenient sampling method.They were divided into two groups with 41 in each group according to the sequence of enrollment.In the experimental group,41 patients were punctured at 4~5 cm near the cardiac end of the styloid process of the radius under the guidance of ultrasound In the control group,41 patients underwent blind puncture and catheterization at the place with thestrongest pulsation of the medial styloid artery of the radius by touch.The success rateof first puncture,the time of indwelling the catheter and the incidence of complications such as bleeding welling,catheter bending catheter blockage and extubation at thepuncture point were compared between the two groups.Results The successrate of first puncture intheexperimental groupwas 95.12%,and the average catheter retention time was(151.49±14.41)h.Compared with the control group,the differences were statistically significant(P<0.05).At thesame time,the incidence of complications inthe indwelling catheter puncture point(4.87%),catheter bending(4.87%)and catheter blockage(0)were lower than those in the control group(P<0.05).Conclusion Ultrasound guided arlerial catheterization at 4~5 cm near the cardiac endof radial styloid process can effectively improve the success rate of first puncture,prolong the indwelling time of arterial catheter,and improve the incidence of complications such as bleeding.