中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2007年
z1期
61-62
,共2页
穿刺置管术%急诊%股静脉%颈静脉
穿刺置管術%急診%股靜脈%頸靜脈
천자치관술%급진%고정맥%경정맥
Catheterization%Emergency%Internal jugular vein%Femoral vein
目的 比较手术室外行急诊颈内静脉与股静脉穿刺置管的优缺点.方法 手术室外行急诊深静脉穿刺置管患者206例,按照首次穿刺的血管分为右颈内静脉组110例和右股静脉组96例.分别记录2组的首次置管成功率、操作完成时间和并发症发生情况.采用SAS 6.04软件包对2组数据行t检验和非参数统计分析.结果 2组患者的病情、年龄、体重、性别相似,最终均完成深静脉穿刺置管,无气胸、心跳骤停等发生.右颈内静脉组首次成功率为88%(97/110),右股静脉组为100%(96/96)(P<0.05);右颈内静脉组操作完成时间为(21.5±8.4)min,右股静脉组为(12.5±5.3)min(P<0.05).右颈内静脉组有7例误穿动脉,其中4例血肿形成,而右股静脉组仅2例误穿动脉,无血肿形成.心电监护显示右颈内静脉组有6例发生心律失常(室性期前收缩、短阵室性心动过速),右股静脉组无心律失常发生(P<0.05).结论 手术室外危重患者的急诊深静脉穿刺置管选择股静脉为穿刺途径,具有安全简便、成功率高、并发症少的优点.
目的 比較手術室外行急診頸內靜脈與股靜脈穿刺置管的優缺點.方法 手術室外行急診深靜脈穿刺置管患者206例,按照首次穿刺的血管分為右頸內靜脈組110例和右股靜脈組96例.分彆記錄2組的首次置管成功率、操作完成時間和併髮癥髮生情況.採用SAS 6.04軟件包對2組數據行t檢驗和非參數統計分析.結果 2組患者的病情、年齡、體重、性彆相似,最終均完成深靜脈穿刺置管,無氣胸、心跳驟停等髮生.右頸內靜脈組首次成功率為88%(97/110),右股靜脈組為100%(96/96)(P<0.05);右頸內靜脈組操作完成時間為(21.5±8.4)min,右股靜脈組為(12.5±5.3)min(P<0.05).右頸內靜脈組有7例誤穿動脈,其中4例血腫形成,而右股靜脈組僅2例誤穿動脈,無血腫形成.心電鑑護顯示右頸內靜脈組有6例髮生心律失常(室性期前收縮、短陣室性心動過速),右股靜脈組無心律失常髮生(P<0.05).結論 手術室外危重患者的急診深靜脈穿刺置管選擇股靜脈為穿刺途徑,具有安全簡便、成功率高、併髮癥少的優點.
목적 비교수술실외행급진경내정맥여고정맥천자치관적우결점.방법 수술실외행급진심정맥천자치관환자206례,안조수차천자적혈관분위우경내정맥조110례화우고정맥조96례.분별기록2조적수차치관성공솔、조작완성시간화병발증발생정황.채용SAS 6.04연건포대2조수거행t검험화비삼수통계분석.결과 2조환자적병정、년령、체중、성별상사,최종균완성심정맥천자치관,무기흉、심도취정등발생.우경내정맥조수차성공솔위88%(97/110),우고정맥조위100%(96/96)(P<0.05);우경내정맥조조작완성시간위(21.5±8.4)min,우고정맥조위(12.5±5.3)min(P<0.05).우경내정맥조유7례오천동맥,기중4례혈종형성,이우고정맥조부2례오천동맥,무혈종형성.심전감호현시우경내정맥조유6례발생심률실상(실성기전수축、단진실성심동과속),우고정맥조무심률실상발생(P<0.05).결론 수술실외위중환자적급진심정맥천자치관선택고정맥위천자도경,구유안전간편、성공솔고、병발증소적우점.
Objective To evaluate the advantages and disadvantages of inserted internal jugular vein cathe-ters and femoral vein catheters in emergency patients outside the operation room.Methods 206 patients received right internal vein catheterization(group J,n=110)and right femoral vein catheterization(group F,n=96).Suc-cessful rates of puncture,operation time,incidence of complications were observed and compared between the two groups.SAS6.04 software was used to analyze the data of the two groups.Results Emergency deep venous catheter-ization was accomplished in all the patients.There were no severe complication in two groups,such as pneumothorax and cardiac arrest.The rate of successful puncture in group J was 88%(97/110),however,100%(96/96)in group F.There was statistical significant difference between two groups(P<0.05).Mean time needed in group J (21.5±8.4)m was more than that in group F(12.5±5.3)min(P<0.05).The cases of puncturing into artery or serious arrhythmia in group F(2 cases)were less than that in group J(7 cases including hematoma in 4 cases)(P<0.05).6 cases were found to have arrhythmia in group J but there was not arrhythmia in group F(P<0.05).Con-chsion Different ways of emergency deep venous catheterization should be selected according to different condi-tions of patients outside the operation room.For critically ill patients,femoral vein puncture is more safe,with high rate of Success and less complication.
