国际麻醉学与复苏杂志   2015, Issue (8): 0-0
    
双向置管导丝架在深静脉穿刺中的应用
夏焱志1()
1.江苏省阜宁县人民医院麻醉科224400
The application of bi-directional catheter guide wire frame in deep vein puncture
 全文:
摘要:

目的 为了更快、更方便、更安全地完成深静脉穿刺操作。 方法 选择手术、化疗、胃肠外深静脉营养、长期输液等各科需要深静脉置管的患者200例。采用随机数字表法将患者分为A、B两组,每组100例。A组用普通导丝架,B组用双向置管导丝架,每组穿刺入路都选择胸前外侧腋静脉。每例都由同一位医师操作,穿刺失败或改用其他穿刺入路方法者不进入观察比较。观察并记录一次性穿刺顺利的例数、导丝折弯例数、另端导丝重置入例数、平均操作时间和血管损伤例数。 结果 B组一次性穿刺顺利的例数、导丝折弯例数、另端导丝再置入例数和A组比较差异无统计学意义(P>0.05)。平均操作时间A组7.5 min, B组4.8 min;血管损伤例数A组6例,B组2例;B组平均操作时间和血管损伤例数与A组比较明显减少,差异有统计学意义(P<0.05)。 结论 用改进的双向置管导丝架穿刺更快、更简便,安全可靠,并发症少。

关键词: 腋静脉; 导丝架; 并发症
Abstract:

Objective To accomplish the deep vein puncture operation quicker, safer and more convenient. Methods Selected 200 patients who need deep vein catheterization, due to operation, chemotherapy, parenteral nutrition, long-term infusion or others. The patients were divided into group A and group B according to the random number table method. Ordinary wire frame was used in group A patients, while bi-directional catheter guide wire frame in group B patients, and each group having 100 cases. The vein puncture methods from anterolateral axillary were used in both groups. Each patient was operated by the same doctor. The puncture failure or other puncture approach did not be selected. Then we observed punctures and counted the number of successful cases in one take, cases of the guide wire bending, cases of the other end of the guide wire reimplantation, the average operation time and cases of vascular injury. Results In group B, the number of successful cases in one take, cases of guide wire bending and cases of the other end of the guide wire reimplantation showed no remarkable difference from the number of group A(P>0.05). The average operation time in group A was 7.5 min, 4.8 min in group B. Six patients suffered vascular injury in group A, while 2 patients in group B. When compared with the group A, the average operation time and vascular injury decreased significantly(P<0.05). Conclusions The puncture with improved bi-directional catheter guide wire frame is a faster, safer, more convenient and reliable method, and fewer complications.

Key words: Axillary vein; Guide wire frame; Complications