股静脉留置针在外周静脉穿刺困难的休克患者急救中的应用研究(审稿意见)

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1、股静脉留置针在外周静脉穿刺困难的休克患者急救中的应用研究摘要：目的：探讨股静脉留置针穿刺和中心静脉置管术在抢救外周静脉穿刺困难的休克患者时的应用效果，找寻能迅速、有效的建立静脉输液通路的途径，从而提高抢救成功率。方法：将142例外周静脉穿刺困难的休克患者随机分成实验组与对照组各71例。实验组釆用留置针行股静脉穿刺输液，对照组经中心静脉置管建立输液通路。从穿刺时间、首次穿刺成功率、置管时间、并发症发生情况进行比较。结果：两组患者穿刺时间、留置时间比较差异有统计学意义(P〈0・05)。实验组患者导管脱落的发生率高于对照组，而气胸、血栓形成、穿刺局部血肿的发

2、生率均比对照组低，两组首次穿刺成功率、导管堵塞、误穿动脉的发生率比较差界无统计学意义(P>o.05)o结论：采用留置针行股静脉穿刺成功率高，所需时间短、并发症少，操作简便、易行，易于掌握；费用低廉，可替代中心静脉置管术在基层医院普遍推广用于外周静脉穿刺困难的休克患者的急救工作中。关键词留置针；股静脉穿刺；中心静脉置管；颈内静脉置管；休克；急救ApplicationofFemoralVenousIndwellingNeedleinRescuingShockPatientswithPeripheralVenipunctureDifficultyAbstra

3、ct:Objective:Toexploretheeffectsoffemoralvenousindwellingneedleandcentralvenouscatheterizationinrescuingshockpatientswithperipheralvenipuncturedifficulty,insearchforaquickandeffectivevenousaccesssoastoimproverescuesuccessrate.Methods:142shockpatientswithperipheralvenipuncturedif

4、ficultywererandomizedintothetestgroupandcontrolgroup,eachincluding71patients.Thetestgroupreceivedfemoralvenipunctureinfusionwithindwellingneedle,andthecontrolgroupreceivedcentralvenouscatheterizationtoestablishvenousaccess-Thetwogroupswerecomparedforpuncturetime,one-timepuncture

5、successrate,catheterindwellingtime,andcomplications.Results:Thereweresignificantdifferencesbetweenthetwogroupsinpuncturetimeandcatheterindwellingtime(P<0.05).Theincidenceofcathetersheddingwashigherinthetestgroupthaninthecontrolgroup;theincidencesofpneumothorax,thrombosis,hematom

6、aatpuncturesitewerelowerthaninthecontrolgroup;andtherewerenostatisticallysignificantdifferencesbetweenthetwogroupsinone-timepuncturesuccessrateortheincidenceofcatheterocclusionorundesirablearterypenetration(P>0.05)Conclusion:Femoralvenipuncturewithindwellingneedleproducedhighers

7、uccessrate,requiredshortertime,resultedinlesscomplications,andinvolvedsimpleprocedures,which,inadditiontothelowcost,supportsitsextensiveuseinplaceofcentralvenouscatheterizationintherescueofshockpatientswithperipheralvenipuncturedifficultyinprimaryhospitals.Keywords:IndwellingNee

8、dle；FemoralVenipuncture；CentralVenousCatheteriz