超声引导下双线定位技术在桡动脉穿刺中的应用
郝帅 池萍 贺海丽 权哲峰▲
首都医科大学附属北京佑安医院麻醉科,北京 100069
Application of ultrasound-guided double-line localization in radial artery puncture
HAO Shuai CHI Ping HE Haili QUAN Zhefeng▲
Department of Anesthesiology, Beijing You′an Hospital, Capital Medical University, Beijing 100069, China
摘要 目的 探讨超声引导下双线定位技术在桡动脉穿刺中的临床效果。 方法 选取2018年9月~2019年6月首都医科大学附属北京佑安医院拟行桡动脉穿刺的患者80例,依据随机数字表法将其分为对照组和观察组,每组40例。对照组采用常规超声引导下桡动脉穿刺,观察组采用双线隔离线定位技术,比较两组首次穿刺成功率、穿刺失败率、超声定位时间和并发症发生情况。 结果 观察组首次穿刺成功率高于对照组,超声定位时间短于对照组,差异均有统计学意义(均P < 0.05);两组穿刺失败率比较,差异无统计学意义(P > 0.05)。观察组出血发生率低于对照组,差异有统计学意义(P < 0.05)。 结论 双线隔离线定位技术能明显提高超声引导下桡动脉穿刺的首次穿刺成功率和超声定位时间。
关键词 :
双线定位 ,
桡动脉 ,
超声引导
Abstract :Objective To investigate the clinical effect of ultrasound-guided double-line localization in radial artery puncture. Methods From September 2018 to June 2019, a total of 80 patients who planned to undergo radial artery puncture in Beijing You′an Hospital of Capital Medical University were selected. According to the random number table method, they were divided into control group and observation group, with 40 cases in each group. Control group received conventional ultrasound-guided radial artery puncture, and observation group received double-line localization technology. The success rate of the first puncture, the rate of puncture failure, ultrasonic positioning time and the incidence of complications were compared between two groups. Results The success rate of the first puncture in observation group was higher than those in control group, the ultrasonic positioning time of observation group was shorter than that of control group, and the differences were statistically significance (all P < 0.05). There was no significant difference in the rate of puncture failure between two groups (P > 0.05). The incidence of bleeding in observation group was lower than that in control group, and the difference was statistically significant (P < 0.05). Conclusion The first puncture success rate and ultrasonic positioning time of the radial artery puncture under the guidance of ultrasound can be improved significantly under the double-line localization technique.
Key words :
Double-line localization
Radial artery
Ultrasound-guided
基金资助: 北京市科学技术委员会首都临床特色应用研究项目(Z171100001017036)。
通讯作者:
▲通讯作者
[1] Anantasit N,Cheeptinnakorntaworn P,Khositseth A,et al. Ultrasound versus traditional palpation to guide radial artery cannulation in critically ill children:a randomized trial [J]. J Ultrasound Med,2017,36(12):2495-2501.
[2] Kherad B,K?觟hncke C,Spillmann F,et al. Postprocedural radial artery occlusion rate using a sheathless guiding catheter for left ventricular endomyocardial biopsy performed by transradial approach [J]. BMC Cardiovasc Disord,2016,16(1):253.
[3] Aouad-Maroun M,Raphael CK,Sayyid SK,et al. Ultrasound-guided arterial cannulation for paediatrics [J]. Cochrane Database Syst Rev,2016,9:CD 011 364.
[4] Kiberenge RK,Ueda K,Rosauer B. Ultrasound-guided dynamic needle tip positioning technique versus palpation technique for radial arterial cannulation in adult surgical patients:a randomized controlled trial [J]. Anesth Analg,2018,126(1):120-126.
[5] Hansen MA,Juhl-Olsen P,Thorn S,et al. Ultrasonographyguided radial artery catheterization is superior compared with the traditional palpation technique:a prospective,randomized,blinded,crossover study [J]. Acta Anaesthesiol Scand,2014,58(4):446-452.
[6] Gopalasingam N,Hansen MA,Thorn S,et al. Ultrasound-guided radial artery catheterisation increases the success rate among anaesthesiology residents:a randomised study [J]. J Vasc Access,2017,18(6):546-551.
[7] Seto AH,Roberts JS,Abu-Fadel MS,et al. Real-time ultrasound guidance facilitates transradial access:RAUST(radial artery access with ultrasound trial)[J]. JACC Cardiovasc Interv,2015,8(2):283-291.
[8] Peters C,Schwarz SK,Yarnold CH,et al. Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators:a randomized trial among Canadian cardiac anesthesiologists [J]. Can J Anaesth,2015,62(11):1161-1168.
[9] Zaremski L,Quesada R,Kovacs M,et al. Prospective comparison of palpation versus ultrasound-guided radial access for cardiac catheterization [J]. J Invasive Cardiol,2013,25(10):538-542.
[10] Tangwiwat S,Pankla W,Rushatamukayanunt P,et al. Comparing the success rate of radial artery cannulation under ultrasound guidance and palpation technique in adults [J]. J Med Assoc Thai,2016,99(5):505-510.
[11] Laursen CB,Pedersen RL,Lassen AT. Ultrasonographically guided puncture of the radial artery for blood gas analysis:a prospective,randomized controlled trial [J]. Ann Emerg Med,2015,65(5):618-619.
[12] Peters C,Schwarz SK,Yarnold CH,et al. Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators:a randomized trial among Canadian cardiac anesthesiologists [J]. Can J Anaesth,2015, 62(11):1161-1168.
[13] Tang L,Wang F,Li Y,et al. Ultrasound guidance for radial artery catheterization:an updated meta-analysis of randomized controlled trials [J]. PLoS One,2014,9(11):e 111 527.
[14] Nakayama Y,Inagaki Y,Nakajima Y,et al. A practical training program for peripheral radial artery catheterization in adult patients:a prospective,randomized controlled trial [J]. Anesthesiology,2016,125(4):716-723.
[15] 权哲峰,池萍,张本厚,等.超声引导桡动脉穿刺置管的临床应用效果[J].临床麻醉学杂志,2014,30(1):56-57.
[16] 罗超,池萍,权哲峰,等.显影线辅助定位实时超声引导用于颈内静脉穿刺置管术的临床价值[J].中华麻醉学杂志,2015,35(2):253-254.
[17] Nakayama Y,Nakajima Y,Sessler DI,et al. A novel method for ultrasound-guided radial arterial catheterization in pediatric patients [J]. Anesth Analg,2014,118(5):1019-1026.
[18] Liu L,Tan Y,Li S,et al. “Modified dynamic needle tip positioning” short-Axis,out-of-Plane,ultrasound-guided radial artery cannulation in neonates:a randomized controlled trial [J]. Anesth Analg,2019,129(1):178-183.
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