不同时机局麻对超声引导下PICC置管术引起的疼痛和穿刺次数的影响

白茹; 陈永侠; 王莉; 张静

doi:10.13898/j.cnki.issn.1000-2200.2021.06.029

不同时机局麻对超声引导下PICC置管术引起的疼痛和穿刺次数的影响

Effect of the local anesthesia in different time on the pain caused by ultrasound-guided PICC catheterization and puncture times

摘要

摘要:
目的对不同时机局麻后PICC置管所致疼痛和穿刺次数进行比较。
方法选择2018-2019年在蚌埠市某三甲医院进行PICC置管的病人90例，按照随机数字法分为对照组（穿刺后麻醉）和观察组（穿刺前麻醉），每组各45例。评估2组穿刺对病人疼痛及穿刺次数的影响。
结果观察组与对照组局部疼痛程度评分差异无统计学意义（P>0.05）。观察组穿刺次数多于对照组（P < 0.05）。观察组局麻前血管直径大于局麻后（P < 0.05），局麻前后血管距皮的距离变化无统计学意义（P>0.05）。
结论在行超声引导下改良塞丁格技术PICC置管时，穿刺前麻醉与穿刺后麻醉对于病人的疼痛无影响，但穿刺前麻醉会导致血管收缩，增加穿刺难度。

Abstract:
ObjectiveTo compare the pain caused by peripherally inserted central catheter(PICC) catheterization and number of punctures after local anesthesia at different time.
MethodsFrom 2018 to 2019, 90 patients treated with PICC catheterization at a grade A tertiary hospital in Bengbu city were randomly divided into the control group(post-puncture anesthesia) and observation group(pre-puncture anesthesia)(45 cases in each group).The effects of puncture on patients' pain and number of puncture were evaluated in two groups.
ResultsThere was no statistical significance in local pain scores between two groups(P>0.05).The number of puncture in observation group was more than that in control group(P < 0.05).The diameter of blood vessels before local anesthesia in observation group was larger than that after local anesthesia(P < 0.05), and there was no statistical significance in the distance from blood vessels to skin between before and after local anesthesia(P>0.05).
ConclusionsThe PICC catheterization with modified seldinger technique guided by ultrasound is performed, the pre-puncture anesthesia and post-puncture anesthesia had no effect on the patient's pain, but the pre-puncture anesthesia can lead to the vasoconstriction and increase the difficulty of puncture.

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