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目的评价超声引导下行深静脉穿刺置管术建立血管通路在血液透析中的应用价值。方法选择本院肾科2015年透析患者200例,按就诊序号2∶1比例分为超声定位组(A组)132例和体表解剖标志定位组(B组)68例,观察两组置管成功率、第1针穿刺成功率、穿刺时间、并发症(置管后2周内感染情况、血肿、误穿动脉)。采用SPSS 16.0统计软件进行分析。结果两组置管成功率均是100%,差异无统计学意义(P>0.05);A组颈内静脉和股静脉第1针穿刺成功率分别为96.0%和93.3%,高于B组70.0%和62.5%;A组颈内静脉和股静脉穿刺平均时间分别为(7.15±2.59)min和(7.43±3.29)min,与B组的(11.24±6.49)min和(12.80±5.78)min比较,A组明显少于B组(P<0.05);并发症(血肿)A组1例(0.7%),明显少于B组并发症(血肿、误穿动脉)4例(5.8%);置管2周内感染率A组3例(2.2%)低于B组5例(7.3%)。结论在超声引导下行深静脉穿刺置管术可以提高第一针穿刺成功率,减少穿刺操作时间,减少并发症,值得在血液透析深静脉置管术中推广应用。
Objective To evaluate the value of ultrasound guided deep venous catheterization in the establishment of vascular access in hemodialysis. Methods A total of 200 dialysis patients from our department were enrolled in this study. They were divided into two groups according to the ratio of 2: 1: 132 cases in group A and group B in 68 cases. Success rate, the success rate of the first needle puncture, puncture time, complications (infection within 2 weeks after catheterization, hematoma, wrongly worn artery). Using SPSS 16.0 statistical software for analysis. Results The success rate of catheterization in both groups was 100%, the difference was not statistically significant (P> 0.05). The successful rates of needle puncture of the internal jugular vein and femoral vein in group A were 96.0% and 93.3%, respectively, which were higher than those in group B 70.0 %, And 62.5% respectively. The mean time of puncture of the internal jugular vein and femoral vein in group A was (7.15 ± 2.59) min and (7.43 ± 3.29) min, respectively, compared with that in group B (11.24 ± 6.49) min and (12.80 ± 5.78) min (P <0.05). Complication (hematoma) in group A was less than that in group B (0.7%) in group A (4 cases, 5.8%). The infection rate in group A was lower in 3 cases (2.2%) than in group B in 5 cases (7.3%) in 2 weeks. Conclusion Ultrasound guided deep venous catheterization can improve the success rate of the first needle puncture, reduce the puncture operation time and reduce the complications, so it is worth popularizing and applying in the hemodialysis deep vein catheterization.