B超实时引导血管穿刺置管在婴幼儿先心病手术中的应用

doi:10.3969/j.issn.1671-7171.2021.11.008

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (1184 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract 【Objective】To evaluate the clinical effect of B-ultrasound real-time guided arteriovenous puncture in surgical treatment of congenital heart disease in infants. 【Methods】In this research, 70 cases of infants with congenital heart disease to receive catheterization for arteriovenous puncture with elective surgery are selected, including 36 boys and 34 girls aged 0~1, ASA classification Ⅱ~Ⅲ. Cases are divided by random number table into an ultrosound group and an anatomical group, each of 35 patients: the ultrasound group with ultrasonic short axis/out-of-plane location of radial artery and jugular vein; the anatomical group, using the traditional anatomical positioning method to locate radial artery and jugular vein for catheterization. 【Results】Radial artery puncture: the ultrasound group showed shorter total puncture time, fewer total puncture times and smaller number of puncture needles used than the anatomical group; the anatomical group showed more cases of arterial hematoma, hemorrhage and other complications than the ultrasound group; all the above differences were statistically significant. Internal jugular vein puncture: the overall success rate and first-time success rate of internal jugular vein catheterization on the right side of infants in the ultrasound group were higher than those of the anatomical group, with puncture time longer than the anatomical group but needle insertion times and puncturing points fewer than the anatomical group. The incidence of mis-operation into arteries in the ultrasound group was significantly lower than the anatomical group. All the above differences were statistically significant. 【Conclusion】 Compared with the traditional blind catheterization method, B-ultrasound guided arteriovenous puncture in surgical treatment of congenital heart disease in infants shows higher success rate and fewer complications and saves more time for rescue. Therefore, it is worth widespread application in clinical practice.

Key words： Heart Defects, Congenital/SU Cardiac Surgical Procedures Ultrasonography Punctures/MT Catheters, Indwelling

Received: 13 July 2021

PACS:

R726.541

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	CHEN Xiao-feng
	LI Zhi-jian
	DAI Ru-ping
	et al

Cite this article:

CHEN Xiao-feng,LI Zhi-jian,DAI Ru-ping, et al. Application of B-ultrasound Real-time Guided Arteriovenous Puncture in Surgical Treatment of Congenital Heart Disease in Infants[J]. JOURNAL OF CLINICAL RESEARCH, 2021, 38(11): 1628-1631.

URL:

http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2021.11.008 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2021/V38/I11/1628

[1] 朱义,杜真,汪丽娜,等.超声引导在婴儿桡动脉穿刺置管中的应用[J].临床小儿外科杂志,2019,18(8):699-702.
[2] 吴赤,彭哲哲,白洁,等.改良超声引导动态针尖定位技术与解剖标志定位用于婴幼儿颈内静脉穿刺的比较[J].医学综述,2020,26(24):4968-4972.
[3] MILLER A G, BARDIN A J. Review of ultrasound-guided radial artery catheter placement[J].J Respir Care,2016,61(3): 383-388.
[4] LEE D,KIM J Y, KIM H S, et al. Ultrasound evaluation of the radial artery for arterial catheterization in healthy anesthetized patients [J].J Clin Monit Comput,2016,30(2):215-219.
[5] NAKAYAMA Y, NAKAJIMA Y, SESSLER D I, et al. A novel method for ultrasound-guided radial arterial catheterization in pediatric patients [J].Anesth Analg,2014, 118(5):1019-1026.
[6] MILLING T J,ROSE J,BRIGGS W M,et al. Randomized, controlled clinical trial of point-of-care limited ultrasonography assistance of central venous cannulation: the Third Sonography Outcomes Assessment Program (SOAP-3) Trial[J].Crit Care Med,2005,33(8):1764-1769.
[7] MOORE C L. Ultrasound first, second, and last for vascular access [J].J Ultrasound Med,2014,33(7):1135-1142.
[8] SINGH Y,TISSOT C,FRAGA M V,et al. International evidence-based guidelines on Point of Care Ultrasound(POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care(ESPNIO[J].Crit Care,2020,24(1):65.
[9] 张龙新,林传涛,陈小琳.超声引导技术在新生儿颈内静脉穿刺置管中的应用[J].中华医学超声杂志(电子版),2012,9(6):16-18.
[10] 陶永忠,钱晓芹.彩超在颈内静脉穿刺置管术中的解剖定位及临床应用[J].临床麻醉学杂志,2010,12:12-16.
[11] LIU L,TAN Y,LI S,et al. "Modified dynamic needle tip positio-ning" short-axis, out-of-plane, ultrasound-guided radial artery cannulation in neonates [J].Anesth Analg,2019,129(1): 178-183.
[12] CLEMMESEN L,KNUDSEN L, SLOTH E, et al. Dynamic needle tip posi-tioning-ultrasound guidance for peripheral vascular access. A ran-domized,controlled and blinded study in phantoms performed by ultrasound novices[J].Ultraschall Med,2012,33( 7) : E321-325.
[13] OMID M, RAFIEI M H, HOSSEINPOUR M,et al. Ultrasound-guided percutaneous central venous catheterization in infants: learning curve and related complications[J].Adv Biomed Res,2015,4:199.