CAJ | 학술논문

目的：比较超声引导下短轴平面外与长轴平面内技术应用于肥胖患者外周静脉穿刺的效果.方法便利选取2013年6月至2014年2月行择期骨科手术且体质指数＞30的患者150例，按投币法随机分为两组，每组各75例，分别以短轴平面外和长轴平面内技术进行超声引导下的贵要静脉穿刺.比较两种方法的操作时间、穿刺效果及两组患者的满意度.结果长轴平面内组图像定位时间多于短轴平面外组(P＜0．05)，但穿刺时间少于后者(P＜0．05)，总操作时间差异无统计学意义(P＞0．05)；长轴平面内组穿刺次数少于短轴平面外组(P＜0．05)，一次穿刺成功率高于后者(P＜0．05)，并发症发生率差异无统计学意义(P＞0．05)；长轴平面内组患者的满意度高于短轴平面外组(P＜0．01).结论短轴平面外和长轴平面内这两种超声引导技术都能获得良好的外周静脉穿刺效果，其中长轴平面内技术所需的图像定位时间虽长，但一旦定位成功后穿刺时间较短、成功率更高，患者痛苦更少，更值得临床推广应用.
목적：비교초성인도하단축평면외여장축평면내기술응용우비반환자외주정맥천자적효과.방법편리선취2013년6월지2014년2월행택기골과수술차체질지수＞30적환자150례，안투폐법수궤분위량조，매조각75례，분별이단축평면외화장축평면내기술진행초성인도하적귀요정맥천자.비교량충방법적조작시간、천자효과급량조환자적만의도.결과장축평면내조도상정위시간다우단축평면외조(P＜0．05)，단천자시간소우후자(P＜0．05)，총조작시간차이무통계학의의(P＞0．05)；장축평면내조천자차수소우단축평면외조(P＜0．05)，일차천자성공솔고우후자(P＜0．05)，병발증발생솔차이무통계학의의(P＞0．05)；장축평면내조환자적만의도고우단축평면외조(P＜0．01).결론단축평면외화장축평면내저량충초성인도기술도능획득량호적외주정맥천자효과，기중장축평면내기술소수적도상정위시간수장，단일단정위성공후천자시간교단、성공솔경고，환자통고경소，경치득림상추엄응용.
Objective To investigate the application effects of short axial plane and long axial plane tech-nologies in obese patients with peripheral venous puncture.Methods By convenience sampling,150 patients were selected and equally divided into out-of-plane technique with vertical scan and in-plane tech-nique with longitudinal scan group.The operation time,puncture effect and satisfaction level were compared between two groups.Results The image positioning time in in-plane technique with longitudinal scan group was longer than which in out-of-plane technique with vertical scan (P<0.05),while the puncture time was shorter than out-of-plane technique with vertical scan group (P<0.05),with no statistical signifi-cance showed in operation time(P>0.05).The times of puncture in in-plane technique with longitudinal scan group was less than which in out-of-plane technique with vertical scan group (P<0.05),and the one time success rate was higher than out-of-plane technique with vertical scan group(P<0.05),with no statis-tical significance showed in the incidence of complications (P>0.05 ).The satisfaction level in in-plane technique with longitudinal scan group was higher than that of out-of-plane technique with vertical scan group (P<0.01).Conclusion Peripheral venous puncture with in-plane technique with vertical scan or out-of-plane technique with longitudinal scan guidance both produced good results.In-plane technique with vertical scan had a longer positioning time,a shorter puncture time,high success rate,less pain,which is worth for clinical application.