【摘要】：目的觀察并比較長軸平面內(nèi)、短軸平面外超聲引導(dǎo)平面技術(shù)在肝脾破裂手術(shù)患者有創(chuàng)動脈血壓監(jiān)測置管中的應(yīng)用價值。方法選取本院180例接受手術(shù)治療的肝脾破裂患者,分為長軸組、短軸組,各90例,均于術(shù)后實施有創(chuàng)動脈血壓監(jiān)測,長軸組于超聲長軸平面內(nèi)引導(dǎo)下行穿刺置管,短軸組于超聲短軸平面外引導(dǎo)下行穿刺置管,比較兩種技術(shù)的效果與安全性。結(jié)果長軸組刺入目標血管時間、總穿刺時間、1次穿刺成功率高于短軸組,其穿刺次數(shù)低于短軸組(P0.05)。長軸組、短軸組并發(fā)癥發(fā)生率分別為7.78%、8.89%(P0.05)。兩組患者置管后6 h SBP、DBP均較置管前上升,其動脈乳酸、去甲腎上腺素用量均下降(P0.05),長軸組、短軸組置管后6 h生命體征組間比較(P0.05)。結(jié)論兩種超聲引導(dǎo)平面技術(shù)均有著良好的安全性,長軸平面內(nèi)技術(shù)具有穿刺成功率高的優(yōu)勢,但穿刺時間較長,進一步優(yōu)化長軸平面內(nèi)引導(dǎo)技術(shù)有望縮短穿刺時間,為該技術(shù)的推廣奠定基礎(chǔ)。
[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.
【作者單位】： 承德醫(yī)學(xué)院附屬醫(yī)院;承德市中心醫(yī)院;
【基金】：承德市科學(xué)技術(shù)研究與發(fā)展計劃項目(201606A027)
【分類號】：R445.1;R657.62

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