2020 年第 11 期 第 15 卷

超声下引导线导航技术在肥胖产妇桡动脉置管中应用的临床研究

Application of ultrasound guided line navigation technology in radial artery catheterization of obese parturient

作者：韩斌徐铭军白云波

英文作者：Han Bin Xu Mingjun Bai Yunbo

单位：

英文单位：Department of Anesthesiology Beijing Obstetrics and Gynecology Hospital Capital Medical University Beijing 100006 China

关键词：桡动脉穿刺；超声引导；肥胖；产妇

英文关键词：Radialarterypuncture;Ultrasoundguidance;Obese;Parturient 

• 摘要：

• 目的 探讨超声下引导线导航技术在肥胖产妇桡动脉置管中的应用情况。方法 选取2019年3月1日至12月31日于首都医科大学附属北京妇产医院接受持续动脉压监测的择期手术肥胖产妇90例，按照随机数字表法分为超声引导组（U组，45例）和传统触诊组（C组，45例）。C组产妇采用触诊桡动脉选择穿刺部位，操作者用左手食指和中指触诊桡动脉脉搏，最强搏动点为穿刺点；U组产妇采用超声穿刺导航模式，将桡动脉横轴切面放置在穿刺引导线位置，在超声探头的探针标记位置穿刺。比较2组产妇穿刺点定位时间、穿刺时间、穿刺成功率和并发症发生情况。结果 U组产妇穿刺点定位时间、穿刺时间均明显短于C组［（26±5）s比（35±7）s、（27±7）s比（31±7）s］，首次穿刺成功率、总穿刺成功率均明显高于C组［82.2%(37/45)比62.2%(28/45)、95.6%(43/45)比80.0%(36/45)］，差异均有统计学意义（均P＜0.05）。U组产妇局部血肿发生率低于C组［8.9%(4/45)比24.4%(11/45)］，差异有统计学意义（P=0.048）。结论 超声下引导线导航技术较传统触诊法更能准确地定位血管穿刺点，可明显提高肥胖产妇桡动脉穿刺置管的成功率并减少相关并发症。

• Objective To explore the application of ultrasound guided line navigation technology in the radial artery catheterization of obese pregnant women. Methods From March 1 to December 31, 2019, 90 obese pregnant women undergoing selective surgery who received continuous arterial pressure monitoring in Beijing Obstetrics and Gynecology Hospital, Capital Medical University were divided into two groups: ultrasound-guided group (group U, 45 cases) and traditional palpation group (group C, 45 cases). In group C, the puncture site was selected by palpation of the radial artery, and the operator palpated the radial artery pulse with the left index finger and middle finger, and the strongest pulse point was the puncture point. The parturients in group U were treated with ultrasound natigation puncture model, and the transverse section of the radial artery was placed at the position of the puncture lead and punctured at the position marked by the probe of the ultrasound probe. The localization time, puncture time, puncture success rate and complications were compared between the two groups. Results The localization time and puncture time in group U were significantly shorter than those in group C［（26±5）s vs （35±7）s,（27±7）s vs （31±7）s］, the success rates of the first puncture and the total puncture were significantly higher than those in group C［82.2%(37/45) vs 62.2%(28/45), 95.6%(43/45) vs 80.0%(36/45)］(all P＜0.05). The incidence of local hematoma in group U was lower than that in group C ［8.9%(4/45) vs 24.4%(11/45),P=0.048］. ConclusionCompared with the traditional palpation method, ultrasound guided line navigation technology can accurately locate blood vessels, significantly improve the success rate of radial artery puncture and catheterization in obese pregnant women and reduce related complications.