Objective To evaluate the application value of ultrasound assessed and guided puncture in PiCCO catheterization in critical patients.Methods 99 cases of critical patients planned to undergo PiCCO monitor during June 2015 and May 2017 in Department of Critical Care Medicine were included,and randomly divided into conventional group(50 patients)and ultrasound group(49 patients).The success rate of catheterization as well as first-time puncture,puncture time and incidence of complications of the two groups were observed and recorded.Anatomical location of femoral artery and vein,statistics of arterial plaque and occlusion in ultrasound group were collected.Data were analyzed by SPSS 18.0.Results The success rate of catheterization in conventional group and ultrasound group was 94％ and 100％,respectively(P ＞ 0.05).Success rate of first-time puncture in conventional group was 56.0％,which was significantly lower than 85.4％ of ultrasound group(P ＜ 0.05).Average puncture time of conventional group was (13.03 ± 5.29) min,significantly longer than (10.84 ± 3.17) min of ultrasound group (P ＜ 0.05).There were 8 cases (16.0％) occurring complications in conventional group,significantly more than 2 cases (4.2 ％) of complications in ultrasound group.Conclusion Femoral artery PiCCO catheterization of critical patients under ultrasound assessment and guidance can promote success rate of both catheterization and first-time puncture,reduce puncture time and complications,worthy of popularization and application in PiCCO monitor technology of Critical Care Medicine.%目的 评价超声评估和引导穿刺,在重症患者PiCCO动脉置管术中的应用价值.方法 选择本院重症医学科2015年6月至2017年5月,拟行PiCCO监测的99例重症患者,随机分为传统组(50人)和超声组(49人);观察两组置管成功率、第一次穿刺成功率、穿刺时间、并发症发生率;收集超声组患者股动静解剖位置、动脉斑块及闭塞数据;采用SPSS 18.0统计软件进行分析.结果 传统组及超声组置管成功率分别是94.0％和100％,差异无统计学意义(P＞0.05);传统组第1针穿刺成功率56.0％,明显低于超声组85.4％,差异有统计学意义(P＜0.05);传统组穿刺平均时间为(13.03 ±5.29) min,明显长于超声组(10.84±3.17) min,差异有统计学意义(P＜0.05);并发症传统组8例(16.0％),明显多于超声组并发症2例(4.2％).结论 在超声评估和引导下行重症患者PiCCO股动脉穿刺置管术,可以提高置管及第一针穿刺成功率,减少穿刺时间,减少并发症,值得在重症医学的PiCCO监测技术中推广应用.
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