不同穿刺方法在桡动脉采血中应用效果比较.docVIP

不同穿刺方法在桡动脉采血中的应用效果比较 　　[摘要] 目的 通过比较两种不同手法经桡动脉穿刺采血的临床效果，探讨临床动脉采血的最佳穿刺方法。方法 将98例患者随机分为对照组和观察组，两组分别采用30°～45°角斜面进针和90°角进针，比较两组患者穿刺成功率、疼痛感及皮下淤血发生情况。结果 观察组一次穿刺成功率明显高于对照组（χ2=7.961，P=0.005）；观察组疼痛发生情况明显低于对照组（χ2=9.56，P=0.023）；观察组皮下淤血情况明显低于对照组（χ2=4.356，P=0.037）；局部血肿发生率明显低于对照组（χ2=4.237，P=0.04）。 结论 垂直进针法对组织损伤小，可提高动脉穿刺采血的成功率、减轻患者疼痛感、降低皮下淤血的发生。 　　[关键词] 穿刺方法；桡动脉采血；应用效果 　　[中图分类号] R472 [文献标识码] B [文章编号] 1673-9701（2014）27-0123-03 　　[Abstract] Objective To compare clinical effects of two different methods of blood through the radial artery puncture， discuss the best methods of clinical arterial puncture blood sampling. Methods A total of 98 patients were randomly divided into control group and observation group， the two groups were used needle bevel angle of 30 to 45 degrees and a 90-degree angle into the needle. The puncture success rate， pain and subcutaneous congestion occurrence in the two groups were observed. Results The success rate of the only one puncture of observation group was significantly higher than the control group （χ2=7.961， P=0.005）； Incidence of pain of observation group was significantly lower than the control group （χ2=9.56， P=0.023）； Subcutaneous congestion situation of observation group was significantly lower than that in the control group （χ2=4.356， P=0.037）； The rate of hematoma in observation group was significantly lower than that in control group（χ2=4.237， P=0.04）. Conclusion Vertical needle method damages tissue less， can improve the success rate of arterial puncture blood， relieve pain patients and reduce the incidence of subcutaneous congestion. 　　[Key words] Puncture methods； Radial artery blood； Application effect 　　动脉血气分析在临床上常用于判断机体是否存在酸碱失衡、缺氧程度及乳酸和电解质指标，是呼吸科判断患者病情危重的重要指标[1]，动脉穿刺采血也是呼吸科常见的专科操作之一。临床上多采用股动脉、桡动脉、肱动脉等部位进行采血。股动脉虽然穿刺成功率高，但是存在不易消毒、冬天脱衣裤不便、呼吸困难时难于采血等弊端[2]；而桡动脉位置表浅、易于消毒、患者暴露少、易于操作、采血后易于压迫、便于观察止血效果，是目前我院首选的采血部位，但是部分患者反映穿刺时疼痛感明显。所以如何提高穿刺成功率，降低患者的疼痛感，是呼吸科护士需要探讨的问题。传统的操作规程中，通常采用中指和食指定位、采血针30°～45°角斜面进针的方法进行动脉穿刺。我院呼吸科采用单指固定血管，采血针90°角进针的方法进行动脉