ISSN 2096-7446　CN 10-1655/R
主管：中国科协技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2023, Vol. 4 ›› Issue (11): 988-992.doi: 10.3761/j.issn.2096-7446.2023.11.005

• 重症管理与质量控制专题 • 上一篇    下一篇

有创血压监测动脉穿刺置管流程的优化及效果评价

杨菲 孙庆梅 潘健 苏玮 吕英 赵群 马英琴 张英英   

  • 出版日期:2023-11-10 发布日期:2023-11-24

Optimization and effect evaluation of arterial puncture catheterization process for invasive blood pressure monitoring

YANG Fei，SUN Qingmei，PAN Jian，SU Wei，LÜ Ying，ZHAO Qun，MA Yingqin，ZHANG Yingying   

  • Online:2023-11-10 Published:2023-11-24

摘要： 目的 采用尖端腔内电图定位技术优化有创血压监测动脉穿刺置管流程，并进行 效果评价。 方法 2021年6月-2022年6月，选取新疆维吾尔自治区某三级甲等医院和某二级甲等医院各60例进行有创血压监测的患者。 依据穿刺方法，采用随机数字表法将研究对象分为优化组和传统组，每组60例。 优化组优化动脉穿刺套管与压力换能器的连接流程，引入动脉穿刺尖端腔内电图定位技术；传统组使用穿透法动脉穿刺置管术。 主要评价指标包括首次置管成功率、穿刺后瘀斑、穿刺出血、疼痛及患者满意度。 结果 与传统组相比，优化组首次置管成功率明显提高（95.0%与83.3%，P=0.04）；穿刺后瘀斑率显著降低（5.0%与 28.3%，P=0.01）；穿刺出血率显著降低（0与100.0%，P=0.04）；轻度疼痛患者比例明显增加 （95.0%与75.0%，P=0.02），而中度疼痛患者比例明显下降（5.0%与25.0%，P=0.02）；患者的满 意度也得到明显提升（95.0%与75.0%，P=0.01）。 结论 有创血压监测动脉穿刺置管的流程优化能有效提高首次穿刺成功率，减少并发症，并增加患者满意度，可提供一种更安全、更高效的置管方法。

关键词: 有创血压监测, 动脉穿刺置管, 电图定位技术, 流程优化, 效果评价

Abstract: Objective To optimize the invasive blood pressure monitoring arterial cannulation procedure using catheter tip intracavitary electrocardiogram （ECG） positioning technology and to evaluate its effectiveness. Methods From June 2021 to June 2022，60 patients each from a tertiary level A hospital and a secondary level A hospital in Xinjiang Uygur Autonomous Region undergoing invasive blood pressure monitoring were selected. Based on the cannulation method，they were randomly divided into the optimization group（60 patients） and the traditional group（60 patients） by the random number table method. The optimization group optimized the connection process be- tween arterial puncture cannula and pressure transducer，and introduced intracavitary electrogram localization tech- nology at the tip of arterial puncture. The traditional group used penetrating arterial puncture catheterization. The primary evaluation indicators included first-attempt cannulation success rate，post-puncture bruising，puncture bleed- ing，pain score，and patient satisfaction. Results Compared to the traditional group，the first-attempt cannulation suc- cess rate in the optimization group significantly increased（95.0% vs 83.3%，P=0.04）. The post-puncture bruising rate significantly decreased（5.0% vs 28.3%，P=0.01）. The puncture bleeding rate significantly decreased（0 vs 100.0%，P= 0.04）. The proportion of patients with mild pain significantly increased（95.0% vs 75.0%，P=0.02），while the propor- tion with moderate pain significantly decreased （5.0% vs 25.0%，P=0.02）. Patient satisfaction also improved（95.0% vs 75.0%，P=0.01）. Conclusion Optimizing the procedure of arterial cannulation for invasive blood pressure moni- toring can effectively improve the first-attempt puncture success rate，reduce complications，and enhance patient sat- isfaction. It offers a safer and more efficient cannulation method.

Key words: Invasive Blood Pressure Monitoring, Arterial Puncture Catheterization, Electrographic Positioning Technology, Process Optimization, Effect Evaluation