锁骨下深静脉与股静脉置管在急诊急危重患者救治中临床应用研究.docVIP

锁骨下深静脉与股静脉置管在急诊急危重患者救治中临床应用研究 　　DOI：10.16662/j.cnki.1674-0742.2017.23.087 　　[摘要] 目的 探?锁骨下深静脉与股静脉置管在急诊急危重患者救治中的临床应用特征与效果。方法 方便选择2015年1月―2016年9月该院收治的98例急诊急危重患者，将其随机分为两组，各49例。对照组采取锁骨下深静脉置管术治疗，观察组予以股静脉置管术治疗。比较两组置管情况、并发症发生情况及舒适度。结果 观察组穿刺成功率为97.96%，明显高于对照组的83.67%，误穿动脉率、导管移位率各为4.08%、0.00%明显低于对照组的18.37%、12.24%，差异有统计学意义（P0.05）；观察组局部血肿与血气胸发生率各为4.08%、0.00%，明显低于对照组的20.40%、14.29%，但深静脉血栓与导管相关感染发生率分别为16.32%、18.37%，明显高于对照组的0.00%、2.04%，观察组舒适度为59.18%，明显低于对照组的89.80%，差异有统计学意义（P0.05）。结论 锁骨下深静脉与股静脉置管术均可作为急诊急危重患者有效的救治方法，两者各有优缺点，临床应用中，应充分考虑诸多因素，选取最佳的置管方案，预防并发症。 　　[关键词] 急诊急危重；锁骨下深静脉；股静脉；应用价值 　　[中图分类号] R459 [文献标识码] A [文章编号] 1674-0742（2017）08（b）-0087-03 　　Clinical Application of Subclavian Deep Vein and Femoral Vein Catheter in Emergency Treatment of Acute and Severe Patients 　　ZHUANG Hui 　　Department of Emergency Surgery， First Affiliated Hospital of Xiamen University， Xiamen， Fujian Province， 361000 China 　　[Abstracts] Objective This paper tries to study the clinical features and effects of deep subclavian vein and femoral vein catheter in acute and severe patients. Methods 98 acute and severe patients treated from January 2015 to September 2016 in this hospital were convenient selected and randomly divided into two groups， with 49 cases in each. The control group adopted deep subclavian vein catheter treatment， the observation group adopted femoral vein catheter treatment. The conditions of catheter， complications and comfort of two groups were compared. Results The success rate of puncture in observation group was 97.96%， higher than that of the control group of 83.67%， the rate of inadvertent arterial puncture and catheter displacement in the observation group were 4.08% and 0.00%， lower than those of the control group of 18.37% and 12.24%（P 　　[Key words] Acute and severe； Deep subclavian vein； Femoral vein； Application value 　　急诊急危重患者往往病情十分严重，变化迅速，急救时常常需大量输血、输液，并进行中心静脉压监测，及时掌握患者体内血液循环情况以及心功能变化情况[1]。深静脉置管术是用于救治危重患者的常用手段之一，通过建立安全、有效的深静脉通道，实现快速液体复苏，补充患者所需营养物质，输注治疗药物，同时能够对患者血流动力学