中国医学科学院学报

高级检索
中国医学科学院学报

中国医学科学院学报 ›› 2020, Vol. 42 ›› Issue (1): 86-90.doi: 10.3881/j.issn.1000-503X.11617

• 论著 • 上一篇    下一篇

超声引导下平面外法桡动脉成功置管和并发症的相关因素

白冰1,田园1,张越伦2,于春华1,黄宇光1()   

  1. 1 麻醉科 中国医学科学院 北京协和医学院 北京协和医院, 北京 100730
    2 科研处中心实验室 中国医学科学院 北京协和医学院 北京协和医院, 北京 100730
  • 收稿日期:2019-06-04 出版日期:2020-02-28 发布日期:2020-03-05
  • 通讯作者: 黄宇光 E-mail:garypumch@163.com

Factors Contributing Successful Ultrasound-guided Radial Artery Cannulation and Its Complications When Using the Short-axis Out-of-plane Procedure

BAI Bing1,TIAN Yuan1,ZHANG Yuelun2,YU Chunhua1,HUANG Yuguang1()   

  1. 1 Department of Anesthesiology, PUMC Hospital,CAMS and PUMC,Beijing 100730,China
    2 Central Research Laboratory,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
  • Received:2019-06-04 Online:2020-02-28 Published:2020-03-05
  • Contact: Yuguang HUANG E-mail:garypumch@163.com

摘要:

目的 寻找超声引导下平面外技术桡动脉置管成功及并发症可能的相关因素。方法 采用多因素Logistic回归分析方法,分析131例使用动态针尖定位法(DNTP) 或角度距离法(AD)行超声引导下平面外技术桡动脉置管的择期手术患者的临床资料,确定一次成功、总体成功、动脉后壁穿透和局部血肿的相关因素。结果 桡动脉前壁深度≥3 mm是穿透后壁(OR=0.314,95%CI:0.143~0.691,P=0.004)和局部血肿(OR=0.250,95%CI:0.107~0.585,P=0.001)的相关因素。使用DNTP方法是穿透后壁(OR=0.303,95%CI:0.138~0.667,P=0.003)的相关因素。结论 超声引导下平面外法动脉穿刺置管时,在桡动脉前壁深度≥3 mm的部位穿刺可以减少穿透后壁和局部血肿的发生率。与AD法相比,DNTP法可减少穿透后壁发生率。

关键词: 桡动脉, 超声, 动脉置管, 相关因素

Abstract:

Objective To identify the possible factors that may influence the success and the complications of ultrasound-guided out-of-plane radial arterial cannulation. Methods Multivariate Logistic regression analysis was used to analyze the clinical data of 131 patients undergoing elective surgery and ultrasound-guided out-of-plane radial artery cannulation,dynamic needle tip positioning(DNTP) technique or angular distance(AD) technique and to find out the factors associated with the one-attempt success rate,overall success rate,posterior arterial wall perforation,and local hematoma. Results The depth of the anterior arterial wall≥3 mm was the factor associated with posterior arterial wall perforation(OR=0.314,95%CI:0.143-0.691,P=0.004) and local hematoma(OR=0.250,95%CI:0.107-0.585,P=0.001).The use of DNTP method was significantly associated with posterior arterial wall perforation(OR=0.303,95%CI:0.138-0.667,P=0.003). Conclusions During ultrasound-guided out-of-plane radial cannulation,puncture at the arterial anterior wall sites with a depth of≥3 mm can reduce the incidence of posterior arterial wall perforation and local hematoma.Compared with AD,DNTP can lower the incidence of posterior arterial wall perforation.

Key words: radial artery, ultrasound, arterial cannulation, related factor

中图分类号: