全身麻醉状态下动脉血气穿刺成功率的影响因素调查

Investigation of factors influencing the success rate of arterial blood gas puncture under general anaesthesia

目的探讨全身麻醉(简称全麻)状态下动脉血气穿刺成功率的影响因素,为临床提高动脉血气穿刺成功率提供参考依据。方法将2020年1月—2022年12月于医院全麻手术期间进行动脉血气穿刺成功的40例患者纳入穿刺成功组,另将同期于医院全麻手术期间进行动脉血气穿刺失败的40例患者纳入穿刺失败组。查阅患者电子病历档案,收集其性别、年龄等一般资料,比较两组患者一般资料及穿刺时血压情况,采用χ2检验Phi系数相关性分析全麻状态下血压变化与动脉血气穿刺成功率的相关性;并采用多因素Logistic回归分析影响动脉血气穿刺成功率的相关因素。结果穿刺失败组穿刺时收缩压在90~140 mmHg、穿刺时舒张压在60~90 mmHg的患者占比低于穿刺成功组(17.50%vs 95.00%、10.00%vs 87.50%),穿刺桡动脉内径小于穿刺成功组[(2.18±0.19)mm vs(2.37±0.15)mm],差异有统计学意义(P<0.05);χ2检验Phi系数相关性结果显示,穿刺时收缩压、舒张压均与动脉血气穿刺成功率有关(Phi=-0.781、-0.775,P<0.05);多因素Logistic回归分析结果显示,穿刺时收缩压、舒张压及穿刺桡动脉内径均为全麻状态下手术患者动脉血气穿刺成功的影响因素(P<0.05)。结论全麻状态下手术患者血压变化与动脉血气穿刺成功率有关,血压过高或过低均会降低动脉血气穿刺成功率,临床在进行动脉血气穿刺时应稳定患者血压在正常范围内,以便确保穿刺成功率,保障手术的顺利进行。

Objective To explore the influencing factors of the success rate of arterial blood gas puncture under general anaesthesia,to provide reference basis for clinical improvement of the success rate of arterial blood gas puncture.Methods To select 40 patients who underwent successful arterial blood gas puncture during general anaesthesia surgery in the hospital from January 2020 to December 2022 in the successful puncture group,and 40 patients who underwent unsuccessful arterial blood gas puncture during general anaesthesia surgery in the hospital during the same period were included in the unsuccessful puncture group.The patients'electronic medical records were examined to collect the general information:gender and age,and the general information and blood pressure at the time of puncture were compared between the two groups.χ2 test was used to analyse the correlation between the changes in blood pressure under general anaesthesia and the success rate of arterial haemopuncture and multifactorial Logistic regression was used to analyse the relevant factors affecting the success rate of arterial haemopuncture.Results The percentage of patients with systolic blood pressure in the range of 90~140 mmHg at the time of puncture and diastolic blood pressure in the range of 60~90 mmHg at the time of puncture in the puncture failure group was lower than that in the puncture success group(17.50%vs 95.00%and 10.00%vs 87.50%,respectively),and the internal diameter of the punctured radial artery was smaller than that of the puncture success group[(2.18±0.19)mm vs(2.37±0.15)mm],the difference was statistically significant(P<0.05).χ2 test Phi coefficient correlation results showed that systolic and diastolic blood pressure at the time of puncture were related to the success rate of arterial blood gas puncture(Phi=-0.781,-0.775,P<0.05);multifactorial Logistic regression analysis showed that systolic blood pressure at the time of puncture,diastolic blood pressure and the internal diameter of the punctured radial artery were the same as those of the patients who had undergone surgery in general anesthesia(P<0.05).The influence factors of successful arterial blood gas puncture in surgical patients(P<0.05).Conclusion Blood pressure changes in surgical patients under general anaesthesia were related to the success rate of arterial blood gas puncture,over high or over low blood pressure will reduce the success rate of arterial blood gas puncture,clinical arterial blood gas puncture should be stabilized when the patient's blood pressure in the normal range,in order to ensure that the success rate of the puncture to ensure that the operation is carried out smoothly.