彩色多普勒超声引导颈内静脉置管在血液透析中应用.docVIP

彩色多普勒超声引导颈内静脉置管在血液透析中应用 　　[摘要] 目的 探讨彩色多普勒超声引导技术在血液透析患者颈内静脉穿刺置管中的应用价值。 方法 回顾性分析2011年10月～2014年12月在我院行血液透析治疗的180例患者的临床资料，其中实施超声引导穿刺置管的患者90例，标记为引导组；采用盲探穿刺置管的患者90例，标记为对照组。观察记录并比较两组患者在实施颈内静脉穿刺置管术时穿刺置管成功率、穿刺操作时间、患者满意度以及术后发生的各类并发症等指标情况。 结果 引导组穿刺置管一次成功率为92.2%，比对照组一次成功率57.8%明显要高；引导组患者满意度（91.1%）也比对照组满意度（70.0%）高；穿刺操作时间对照组（9.20±3.43）min长于引导组（4.56±1.36）min；此外，引导组并发症总发生率2.2%，对照组为42.2%，引导组比对照组并发症发生率明显要低，上述结果差异均具有统计学意义（P0.001）。 结论 行血液透析的尿毒症患者应用彩色多普勒超声引导颈内静脉置管，穿刺的一次成功率高，并发症少，操作简便、快捷。对于解剖变异、穿刺困难者，或穿刺经验不足的医生，操作时宜采用超声实时引导。 　　[关键词]血液透析；彩色多普勒超声引导；颈内静脉穿刺置管术；并发症 　　[中图分类号] R445.1 [文献标识码] B [文章编号] 2095-0616（2015）19-175-04 　　[Abstract] Objective To analyze the application value of internal jugular vein puncture guided by color doppler ultrasound in hematodialysis. Methods A retrospective analysis was performed on clinical data of 180 patients treated with hemodialysis in our hospital from October 2011 to December 2014， 90 patients of them were treated with ultrasound-guided internal jugular vein puncture and were marked as the observation group， the other 90 patients were treated with blind puncture catheter and were marked as the control group. The success rate of puncture， puncture operation time， patient satisfaction and postoperative complications of internal jugular vein catheterization of the two groups were observed and compared. Results The one-time success rate of puncture catheter of the observation group was 92.2%， and significantly higher than that of 57.8% in control group； the satisfaction degree of patients in obervation group was 91.1%， and was higher than that of 70.0% in control group； the puncturing time ofcontrol group was （9.20±3.43）min， which was longer than that of （4.56±1.36） min in observation group； the the occurance of complications in observation group was 2.2%， and was significanly lower than that of 42.2% in control group， the differences were statistically significant（P0.001）. Conclusion The success rate of puncture is high by the color Doppler ultrasound in