心脏射频消融术前时钟定位法超声探查在股静脉穿刺中的应用价值

doi:10.3969/j.issn.1006-5725.2023.16.015

Abstract

Abstract:

Objective This study discussed the application value of preoperative clock positioning ultrasonic exploration in cardiac radio frequency ablation femoral venocentesis. Methods A total of 229 consecutive patients undergoing radiofrequency ablation were randomly divided into two groups： ultrasound group （n = 112） and control group （n = 117）. The patient's arteriovenous clock relationship in the inguinal ligament area， the number of femoral vein catheterization， the number of puncture and the puncture time， the number of accidental artery puncture and vascular complications were recorded. Results Compared with the control group， the total number of punctures and the number of punctures per single catheterization in the ultrasound group were significantly reduced， the puncture time and the single catheterization time were significantly shortened（P < 0.05）. The number of accidental arterial punctures and the puncture related hematoma in the ultrasound group was significantly less than that in the control group （P <0.05）. In subgroup analyses， the puncture time and the average placement time of a single catheter were shorter in the inner-superior group than in the inner-inferior group， and the number of mispunctured arteries was less than in the inner-inferior group （P < 0.05）. Conclusion Preoperative clock positioning ultrasound exploration can effectively reduce the puncture time， improve the success rate of puncture and reduce the complications of puncture， which has certain clinical application value.

Key words: femoral vein, ultrasound, cardiac radio frequency ablation, clock localization method

CLC Number:

R541.7

Juan WANG,Weixiang FENG,Bo XU,Gaojun CAI,Xiaofang LIANG,Sheliang XUE,Yanbin SONG,Tao CHEN,Wenhua. LI. Application value of ultrasonic exploration in femoral vein puncture before cardiac radio frequency ablation[J]. The Journal of Practical Medicine, 2023, 39(16): 2100-2105.

Figures/Tables 8

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References 26

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指标	超声组（n=112）	对照组（n=117）	t值	P值
股静脉位置（钟表定位法，以股动脉为中心）
下3	5.71 ± 0.68	5.56 ± 0.77	1.488	0.138
下2	5.21 ± 0.77	5.04 ± 0.83	1.615	0.108
下1	4.63 ± 0.96	4.48 ± 0.88	1.238	0.217
腹股沟韧带	4.00 ± 0.78	4.04 ± 0.73	-0.474	0.636
上1	3.89 ± 0.54	3.87 ± 0.50	0.303	0.762
上2	3.87 ± 0.549	3.85 ± 0.56	0.231	0.832
股静脉直径
下3	8.14 ± 1.84	8.35 ± 3.49	-0.555	0.580
下2	8.16 ± 1.88	8.43 ± 1.63	-1.182	0.238
下1	9.02 ± 2.09	9.02 ± 1.94	-0.003	0.998
腹股沟韧带	9.69 ± 2.22	9.76 ± 1.93	0.244	0.808
上1	10.63 ± 2.18	10.19 ± 2.16	1.518	0.130
上2	10.67 ± 2.05	11.32 ± 9.58	-0.702	0.484
股动-静脉距离
下3	8.15 ± 1.42	7.91 ± 1.25	1.324	0.187
下2	8.39 ± 1.54	8.46 ± 1.33	0.358	0.721
下1	8.94 ± 1.83	9.01 ± 1.77	-0.323	0.747
腹股沟韧带	9.67 ± 1.89	9.78 ± 1.99	-0.432	0.666
上1	10.94 ± 2.05	10.71 ± 1.96	0.876	0.382
上2	11.37 ± 2.05	10.96 ± 2.12	1.478	0.141
皮肤-股静脉距离
下3	26.46 ± 6.05	26.35 ± 6.37	0.134	0.894
下2	24.62 ± 6.62	23.81 ± 6.72	0.915	0.361
下1	22.27 ± 6.80	22.34 ± 7.03	-0.073	0.942
腹股沟韧带	20.36 ± 5.80	21.05 ± 6.35	-0.850	0.396
上1	23.18 ± 5.92	22.78 ± 6.58	0.477	0.634
上2	24.83 ± 7.28	24.39 ± 6.49	0.484	0.629

指标	超声组（n = 112）	对照组（n = 117）	t值	P值
手术时间（min）	215.23 ± 83.40	198.76 ± 83.60	1.492	0.137
置管数（个）	2.76 ± 0.65	2.92 ± 1.17	-1.307	0.192
穿刺次数（次）	3.24 ± 1.21	4.09 ± 1.80	-4.015	< 0.001
穿刺时间（min）	5.24 ± 3.30	7.22 ± 5.31	-3.373	0.001
单次置管的平均穿刺次数（次）	1.18 ± 0.37	1.49 ± 0.75	-3.919	< 0.001
单根导管平均置管时间（min）	1.90 ± 1.07	2.56 ± 2.03	-3.099	0.002

指标	内上组（n = 85）	内下组（n = 144）	t/χ ²/Z值	P值
年龄（岁）	67（54.5，75）	70（60，74）	-1.393	0.163
女性［例（%）］	36（42.35）	80（55.56）	3.730	0.054
BMI（x ± s，kg/m²）	24.24 ± 3.48	25.09 ± 25.09	-1.650	0.100
腿围（mm）	53（50，56）	53（49，56）	-0.140	0.889
股静脉直径（x ± s，mm）	10.44 ± 2.09	9.31 ± 1.95	4.153	< 0.001
股动-静脉距离（mm）	9.9（8.75，11.75）	9.3（8.125，10.275）	-3.345	0.001
皮肤-股静脉距离（x ± s，mm）	18.46 ± 5.55	22.04 ± 6.01	-4.480	< 0.001
手术时间（x ± s，min）	207.88 ± 97.70	206.19 ± 74.62	0.148	0.883
置管数（个）	3（3，3）	3（2.25，3）	-0.699	0.485
穿刺次数（次）	3（3，4）	3（3，5）	-0.983	0.326
穿刺时间（min）	4（3.75，6）	5（4，8）	-2.102	0.036
单次置管的平均穿刺次数（x ± s，次）	1.24 ± 0.46	1.40 ± 0.69	-1.888	0.060
单根导管平均置管时间（min）	1.67（1.33，2）	2.00（1.33，2.67）	-2.021	0.043
误穿动脉［次（%）］	2（2.35）	13（9.03）	3.890	0.049
血肿［例（%）］	7（8.23）	12（8.33）	< 0.001	1.000
股神经损伤［例（%）］	0（0）	0（0）	-	-
动静脉瘘［例（%）］	0（0）	0（0）	-	-

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Application value of ultrasonic exploration in femoral vein puncture before cardiac radio frequency ablation

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