顺行与逆行静脉穿刺方法的对比研究

Comparative analysis of antegrade versus retrograde venipuncture

目的对比顺行与逆行两种静脉输液穿刺方法的临床应用效果。方法选取我院2015年11月至2016年10月纳入的176例难穿刺血管患者及肥胖者、老年患者,随机将其分为对照组和观察组,每组88例。同样选择手背血管,对照组患者采用常规静脉输液穿刺法,观察组采用逆向静脉输液穿刺法。记录两组患者首次穿刺成功率、二次及以上穿刺成功率以及液体外漏率等。穿刺成功判断标准:穿刺静脉见回血、液体点滴畅通。检测两组患者输液液体流速。结果对照组首次穿刺成功66例,二次及以上成功22例。观察组首次穿刺成功84例,二次及以上成功4例。观察组穿刺首次成功率较对照组高(95.45%vs 75.00%),二次及以上成功率较对照组低(4.55%vs25.00%),两组比较差异有统计学意义(P<0.05)。对照组液体穿刺外漏30例,观察组液体穿刺外漏6例。观察组液体外漏发生率较对照组低(6.82%vs 34.09%),两组比较差异有统计学意义(P<0.05)。对照组和观察组输液液体流速>100gtt/min者分别为80例和84例,组间比较(90.91%vs95.45%)差异无统计学意义(P>0.05)。结论对难穿刺血管患者及肥胖者静脉输液选择手背血管采用逆行穿刺法应用效果理想。

Objective To compare clinical effects of anterograde versus retrograde venous transfusion puncture. Methods 176 cases of patients,including with puncture difficulty,obesity and aged,were collected from November 2015 to October 2016 and randomly divided into control and observation group,88 cases in each group. Dorsal hand vessels were selected for transfusion puncture and anterograde and retrograde puncture were applied in control group and observation group,respectively. The success rates of first puncture,secondary and above,liquid leakage rate were recording. Puncture success criterion: blood returning,liquid drop open. Another infusion liquid flow rate using a stopwatch detection of two groups of patients. Results There were 66 cases of successful puncture in once and 22 cases for twice and above in control group. There were 84 cases of successful puncture in once and 4 cases for twice and above in observation group. The first puncture success rate of observation group was higher than that of control group( 95. 45% vs 75. 00 %),two or more success rate was lower than those of control group( 4. 55% vs 25. 00%). there was statistical significance between two groups( P < 0. 05). There were 30 cases of the liquid puncture leakagein control group and 6 cases of liquid puncture leakage in observation group. The liquid leakage rate in observation group was lower than those of control group( 6. 82% vs 34. 09 %). There is a statistical significance between two groups( P < 0. 05). Infusion liquid flow rate > 100 GTT/min in two groups were 80 cases and 84 cases respectively. There was no statistically significant difference between two groups( P > 0. 715). Conclusions To patients with difficult vessel puncture and obesity,retrograde puncture is an ideal method.