| 吴一鸣,谢鹏程,段宏伟.根据雾气现象判断硬膜外腔导管位置的临床研究[J].安徽医药,2018,22(10):1933-1935. |
| 根据雾气现象判断硬膜外腔导管位置的临床研究 |
| A clinical study on judgment of epidural catheter location based on mist phenomenon |
| 投稿时间：2017-02-17 |
| DOI： |
| 中文关键词: 麻醉,硬膜外 导管插入术 位置指南和标记 蒸汽 判断 |
| 英文关键词: Anesthesia,epidural Catheterization Location directories and signs Steam Judgment |
| 基金项目:上海市浦东新区卫计委卫生科技项目(PW2014A-26) |
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| 中文摘要: |
| 目的 通过临床研究论证雾气现象是否可作为判断硬膜外腔穿刺置管成功与否的重要标准。 方法 选择硬膜外阻滞患者 150 例,采用随机数字表法分为两组,每组75例:对照组根据常规负压方法认定硬膜外导管位于硬膜外腔,不刻意寻找雾气现象。研究组根据雾气现象认定硬膜外导管位于硬膜外腔。两组患者置管后常规给药,根据是否出现硬膜外阻滞效果来最终确认硬膜外导管是否位于硬膜外腔。两组患者都在B超引导下穿刺,穿刺针分别经过皮下脂肪层、肌肉层、韧带时,放置导管回抽观察导管内壁有无雾气现象。 结果 对照组有67例确定在硬膜外腔,其中有63例观察到雾气现象(P=0.000), 8例患者导管不在硬膜外腔,且该8例患者均未出现雾气现象(P=0.000)。研究组75例患者导管均确定在硬膜外腔,且所有患者均观察到雾气现象(P=0.021)；在皮下脂肪层、肌肉层、韧带没有观察到雾气现象。 结论 硬膜外腔雾气现象具有特异性可作为判断硬膜外腔穿刺置管成功与否的重要标准。 |
| 英文摘要: |
| Objective To determine whether mist phenomenon could be used as an important criterion for judging the success or failure of epidural space puncture intubation by clinical study. Methods A total of 150 patients with epidural block were selected and randomly assigned into two groups,75 cases in each group.In control group,routine negative-pressure method was used to determine whether the epidural catheters were located in epidural space without deliberately seeking for the mist phenomenon,while in research group,mist phenomenon was observed to determine whether the epidural catheters were located in epidural space.After catheter indwelling,both groups received routine drug administration,and whether the epidural catheters were located in epidural space were finally determined according to the effect of epidural block.Both groups received Bultrasound-guided puncture,and the indwelled catheters were pumped back to observe whether there was mist phenomenon within catheter walls when the puncture needle passed through subcutaneous fat layer,muscular layer and ligament. Results In control group,67 patients had their catheters located in epidural space,in which 63 had mist phenomenon (P=0.000),while 8 did not have catheters in epidural space and there was no mist phenomenon in these 8 cases (P=0.000).In research group,,all patients had their catheters located in epidural space,and all were observed with mist phenomenon (P=0.021).There was not mist phenomenon in subcutaneous fat layer,muscular layer or ligament. Conclusions Epidural mist phenomenon can be used as an important criterion for judging the success or failure of epidural space puncture intubation because it has high specificity. |
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