心脏射频消融术前时钟定位法超声探查在股静脉穿刺中的应用价值

Application value of ultrasonic exploration in femoral vein puncture before cardiac radio frequency ablation

目的 研究心脏射频消融术前时钟定位法超声探查在股静脉穿刺中的应用价值。方法连续纳入行心射频消融术的患者229例,随机分成超声组(n=112)和对照组(n=117)。记录患者腹股沟韧带区动静脉间钟表关系、股静脉置管数、穿刺次数、穿刺时间、误穿动脉次数以及术后血管并发症。结果 与对照组相比,超声组的总穿刺次数、单次置管的穿刺次数明显减少,穿刺时间、单次置管时间明显缩短(P<0.05);超声组误穿动脉次数和穿刺相关的血肿更少(P<0.05)。亚组分析,内上组穿刺时间、单根导管平均置管时间短于内下组,误穿动脉次数少于内下组(P<0.05)。结论 术前时钟定位法超声探查可以有效减少穿刺时间、提高穿刺成功率以及降低穿刺并发症,具有一定的临床应用价值。

Objective This study discussed the application value of preoperative clock positioning ultra⁃sonic exploration in cardiac radio frequency ablation femoral venocentesis.Methods A total of 229 consecutive patients undergoing radiofrequency ablation were randomly divided into two groups:ultrasound group(n=112)and control group(n=117).The patient's arteriovenous clock relationship in the inguinal ligament area,the number of femoral vein catheterization,the number of puncture and the puncture time,the number of accidental artery puncture and vascular complications were recorded.Results Compared with the control group,the total number of punctures and the number of punctures per single catheterization in the ultrasound group were significantly re⁃duced,the puncture time and the single catheterization time were significantly shortened(P<0.05).The number of accidental arterial punctures and the puncture related hematoma in the ultrasound group was significantly less than that in the control group(P<0.05).In subgroup analyses,the puncture time and the average placement time of a single catheter were shorter in the inner-superior group than in the inner-inferior group,and the number of mis⁃punctured arteries was less than in the inner-inferior group(P<0.05).Conclusion Preoperative clock posi⁃tioning ultrasound exploration can effectively reduce the puncture time,improve the success rate of puncture and reduce the complications of puncture,which has certain clinical application value.