不同超声引导平面技术在肝脾破裂手术患者有创动脉血压监测置管中的应用
发布时间：2019-03-27 16:15
【摘要】：目的观察并比较长轴平面内、短轴平面外超声引导平面技术在肝脾破裂手术患者有创动脉血压监测置管中的应用价值。方法选取本院180例接受手术治疗的肝脾破裂患者,分为长轴组、短轴组,各90例,均于术后实施有创动脉血压监测,长轴组于超声长轴平面内引导下行穿刺置管,短轴组于超声短轴平面外引导下行穿刺置管,比较两种技术的效果与安全性。结果长轴组刺入目标血管时间、总穿刺时间、1次穿刺成功率高于短轴组,其穿刺次数低于短轴组(P0.05)。长轴组、短轴组并发症发生率分别为7.78%、8.89%(P0.05)。两组患者置管后6 h SBP、DBP均较置管前上升,其动脉乳酸、去甲肾上腺素用量均下降(P0.05),长轴组、短轴组置管后6 h生命体征组间比较(P0.05)。结论两种超声引导平面技术均有着良好的安全性,长轴平面内技术具有穿刺成功率高的优势,但穿刺时间较长,进一步优化长轴平面内引导技术有望缩短穿刺时间,为该技术的推广奠定基础。
[Abstract]:Objective to observe and compare the value of long-axis and short-axis out-of-plane ultrasound-guided plane technique in monitoring arterial blood pressure in patients with hepatic and splenic rupture. Methods 180 patients with rupture of liver and spleen were divided into two groups: long axis group (n = 90) and short axis group (n = 90). Invasive arterial blood pressure monitoring was performed after operation in the long axis group, and catheterization was performed in the long axis group under the guidance of ultrasound in the long axis plane. The short axis group was guided out of plane by ultrasound, and the effect and safety of the two techniques were compared. Results the puncture time, total puncture time and successful rate of one puncture in the long axis group were higher than those in the short axis group, and the puncture times were lower than those in the short axis group (P0.05). The incidence of complications in long axis group and short axis group were 7.78% and 8.89% respectively (P0.05). The levels of arterial lactic acid and norepinephrine decreased at 6 h after catheterization in both groups (P 0.05). The vital signs in long axis group and short axis group were compared at 6 h after catheterization (P 0.05). 6 h after catheterization, the levels of arterial lactic acid and norepinephrine decreased in both groups (P0.05). Conclusion both ultrasound-guided plane techniques have good safety and long-axis in-plane technique has the advantage of high puncture success rate, but the puncture time is longer. Further optimization of long-axis in-plane guidance technique is expected to shorten the puncture time. It lays a foundation for the popularization of the technology.
【作者单位】： 承德医学院附属医院;承德市中心医院;
【基金】：承德市科学技术研究与发展计划项目(201606A027)
【分类号】：R445.1;R657.62
[Abstract]:Objective to observe and compare the value of long-axis and short-axis out-of-plane ultrasound-guided plane technique in monitoring arterial blood pressure in patients with hepatic and splenic rupture. Methods 180 patients with rupture of liver and spleen were divided into two groups: long axis group (n = 90) and short axis group (n = 90). Invasive arterial blood pressure monitoring was performed after operation in the long axis group, and catheterization was performed in the long axis group under the guidance of ultrasound in the long axis plane. The short axis group was guided out of plane by ultrasound, and the effect and safety of the two techniques were compared. Results the puncture time, total puncture time and successful rate of one puncture in the long axis group were higher than those in the short axis group, and the puncture times were lower than those in the short axis group (P0.05). The incidence of complications in long axis group and short axis group were 7.78% and 8.89% respectively (P0.05). The levels of arterial lactic acid and norepinephrine decreased at 6 h after catheterization in both groups (P 0.05). The vital signs in long axis group and short axis group were compared at 6 h after catheterization (P 0.05). 6 h after catheterization, the levels of arterial lactic acid and norepinephrine decreased in both groups (P0.05). Conclusion both ultrasound-guided plane techniques have good safety and long-axis in-plane technique has the advantage of high puncture success rate, but the puncture time is longer. Further optimization of long-axis in-plane guidance technique is expected to shorten the puncture time. It lays a foundation for the popularization of the technology.
【作者单位】： 承德医学院附属医院;承德市中心医院;
【基金】：承德市科学技术研究与发展计划项目(201606A027)
【分类号】：R445.1;R657.62
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