论文部分内容阅读
目的探讨应用超声引导自由手技术行脐静脉穿刺在产前诊断中的可行性、成功率及临床价值。方法 2008年9月至2010年3月于上海交通大学医学院附属国际和平妇幼保健院,应用超声引导自由手技术对134例有产前诊断指征的中晚孕孕妇行脐静脉穿刺术(自由手组),明确界定穿刺1次成功的评判标准,并与81例经穿刺架引导行脐静脉穿刺者(穿刺架组)进行对照研究,分析应用自由手技术的优势、影响其一次穿刺成功的因素以及穿刺并发症。结果自由手组与穿刺架组总穿刺成功率及一次进针成功率差异无统计学意义(96.3%、95.1%;64.3%、61.0%),当1次进针穿刺失败,需再次穿刺时,自由手技术可明显减少经皮肤穿刺的次数。穿刺熟练程度、脐静脉直径、前壁胎盘、穿刺路径的长短是影响自由手一次穿刺成功的主要因素,穿刺次数与并发症明显相关。结论超声引导自由手技术经严格训练后可有效提高脐静脉穿刺质量,值得临床推广。
Objective To investigate the feasibility, success rate and clinical value of umbilical vein puncture guided by ultrasound guided free hand in prenatal diagnosis. Methods From September 2008 to March 2010, at the International Peace Maternity and Child Care Hospital affiliated to Shanghai Jiaotong University School of Medicine, 134 cases of pregnant women with prenatal diagnosis of prenatal diagnosis of umbilical vein puncture were treated with ultrasound guided free hand technique Hand group). The criteria for successful primary puncture were defined and compared with 81 cases of puncture-guided umbilical vein puncture (puncture rack group). The advantages of using free-hand technique were analyzed and the success of the first puncture was analyzed Factors and puncture complications. Results There was no significant difference between the success rate of the total puncture and the success rate of the first puncture (96.3%, 95.1%, 64.3%, 61.0%) in the free hand group and the puncture stand group. Free hand technique can significantly reduce the number of transcutaneous puncture. Puncture proficiency, umbilical vein diameter, anterior placenta, the length of the puncture path is the main factor that affects the success of a free hand puncturing. The number of punctures is significantly related to the complication. Conclusion Ultrasound-guided free hand technique can effectively improve the quality of umbilical vein puncture after rigorous training, which is worthy of clinical promotion.