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Objective@#To investigate the clinical significance of Wiguide needle guidance ultrasound technology in radial artery puncture.@*Methods@#One hundred and thirty-five patients who would receive elective surgery requiring radial artery puncture and catheterization to monitor invasive blood pressure were randomly divided into 3 groups(n=45): blind puncture group(group A), ultrasound puncture group(group B) and Wiguide needle guidance ultrasound puncture group(group C). The diameter and depth of radial artery, blood return time, puncture time for the process and the puncture success rate were recorded and compared.@*Results@#There was significant diffeence in the blood return time among three groups (P=0.039), the blood return time in group B was higher than in group A and C (P=0.029, 0.027). The difference was statistically significant in the puncture time among three groups (P=0.002), the puncture time in group B was higher than in group A and C (P=0.009, 0.001). The puncture success rate in group A was 71.11%, the puncture success rate were 100% in both group B and C.@*Conclusions@#Wiguide needle guidance ultrasound technology could effectively improve the skill of vascular puncture, which shortens the puncture time and improves the success rate of puncture. Wiguide needle guidance ultrasound technology provides benefits to master the ultrasound-guided vascular puncture for clinical work.
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Objective To investigate the clinical significance of Wiguide needle guidance ultrasound technology in radial artery puncture . Methods One hundred and thirty‐five patients who would receive elective surgery requiring radial artery puncture and catheterization to monitor invasive blood pressure were randomly divided into 3 groups( n ＝45) :blind puncture group( group A ) ,ultrasound puncture group( group B) and Wiguide needle guidance ultrasound puncture group ( group C ) . T he diameter and depth of radial artery ,blood return time ,puncture time for the process and the puncture success rate were recorded and compared . Results T here was significant diffeence in the blood return time among three groups ( P ＝0 .039) ,the blood return time in group B was higher than in group A and C ( P ＝ 0 .029 ,0 .027 ) . T he difference was statistically significant in the puncture time among three groups ( P ＝0 .002) ,the puncture time in group B was higher than in group A and C ( P ＝0 .009 ,0 .001) . T he puncture success rate in group A was 71 .11% ,the puncture success rate were 100% in both group B and C . Conclusions Wiguide needle guidance ultrasound technology could effectively improve the skill of vascular puncture ,which shortens the puncture time and improves the success rate of puncture . Wiguide needle guidance ultrasound technology provides benefits to master the ultrasound‐guided vascular puncture for clinical work .
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@#Objective To explore the influence of applying the fast-track surgery (FTS) to optimize the process in the perioperative period of cardiac intervention on the rehabilitation of patients with radial artery stenting surgery. Methods A total of 190 patients with radial artery stenting surgery in the Department of Cardiology, West China Hospital from June 2017 to May 2018 were enrolled. They were randomized into a control group (n=95) and a FTS group (n=95) by random umber table. There were 60 males and 35 females aged 35-88 (65.2±9.6) years in the control group as well as 62 males and 33 females aged 34-86 (61.5±11.3) years in the FTS group. Patients in the control group received routine perioperative care, but patients in the FTS group received individual precision interventions by applying the FTS concept to optimize the process of perioperative care, including individual care management before being admitted into hospital, during hospital, and after discharge from hospital. Duration of hospital stay, satisfaction scores, number of comorbidities after surgery, disease self-management ability, and readmission rates were compared between the two groups. Results Compared to the control group, the FTS group had significantly shorter duration of hospital stay, less comorbidities, higher satisfaction scores and disease self-management ability, and lower readmission rate to hospital (P<0.05). Conclusion Applying FTS into the perioperative period of cardiac interventions to optimize its process can help patients recover from radial artery stenting surgery, increase patients’ self-management abilities, shorten duration of hospital stay and decrease comorbidities and cardiac adverse events.
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<p><b>OBJECTIVE</b>To evaluate the effect and clinical value of auricular point sticking for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture, including radial artery spasm (RAS) and coronary artery spasm (CAS).</p><p><b>METHODS</b>A total of 480 patients were randomized into an observation group (224 cases) and a control group (256 cases). Percutaneous coronary intervention and usual care in perioperative period were used in the control group. Auricular point sticking was began to apply 12 h before percutaneous coronary intervention in the observation group at Jiaogan (AH), Shenmen (TF), Pizhixia (AT), Neifenmi (CO), Xin (CO), Shen (CO), Shenshangxian (TG), 1 min a time every point, once every 2 h, 12 h before and after operation. The incidences of vasospasm and vagus reflex during piercing process were compared, and the usage ratios of vasoactive agent were recorded, including glyceryl trinitrate, dopamine and atropine injections.</p><p><b>RESULTS</b>The incidence of angiospasm was 4.9% (11/224) in the observation group, which was lower than 13.3% (34/256) in the control group (<0.01). The incidence of vagal reflex of the observation group was 7.1% (16/224), which was lower than 19.5% (50/256) of the control group (<0.01). The usage ratios of glyceryl trinitrate, atropine and dopamine injections were 3.6% (8/224), 7.1% (16/224), 6.3% (14/224) respectively in the observation group, which were lower than 14.8% (38/256), 15.6% (40/256), 15.2% (39/256) in the control group (all<0.01). .</p><p><b>CONCLUSION</b>Auricular point sticking achieves effect for the diagnosis and treatment of vasospasm and vagus reflex during radial artery puncture.</p>
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Objective To investigate the clinical application and value of retrograde catheterization via superficial femoral artery for the treatment of limb chronic total occlusive disease (CTO). Methods Fifty-nine patients with proximal and middle occlusive lesions of superficial femoral artery from Jan. 2013 to Jan. 2015 in department of emergency surgery were retrospectively analyzed. Percutaneous transluminal angioplasty (PTA) together with stent implantation was performed to reopen the all narrowed or obstructed superficial femoral artery.Seventeen patients received ipsilateral retrograde catheterization via superficial femoral artery together. The length of the diseased artery ranged from 6.5 to 13.4 cm, with a mean of (8.3 ± 2.9) cm, including right (11 cases)and left (8 cases) femoral arteries. After the interventional therapy patients were followed up for 1- 24 months. Results All patients were treated successfully. The proximal and middle occlusive lesions of superficial femoral artery were reopened.No serious complications were found including nerve and vessel damage+After the treatment, the ischemic symptoms were markedly improved or even disappeared. In 14/19 of patients the superficial femoral arteries remained patent during the follow-up period. The ankle preoperative brachial index (ABI) was 0.20 to 0.51 (0.39 ± 0.06), while the postoperative ABI was 0.65 to 1.15 (0.74 ± 0.13). The difference in ABI between pre-operation and post-operation was statistically significant (P<0.05). Conclusions Retrograde catheterization via superficial femoral artery is an effective alternative to treat proximal and middle occlusion of ipsilateral superficial femoral artery. It has high successful rate and safety.
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Objective To investigate the efficacy of transradial approach in the treatment of acute myocardial infarction (AMI) with direct coronary intervention and its influence on inflammatory factors. Methods One hundred and forty-six patients with acute ST elevation myocardial infarction were randomly divided into radial artery group and femoral artery group with 73 cases in each group. The patients in radial artery group received transradial percutaneous coronary intervention (PCI) by transradial approach, and those in the femoral artery group were treated with PCI by transfemoral approach. The operation time, puncture to balloon opening time, X-ray exposure time, contrast agent dosage, the success rate of PCI, reperfusion arrhythmia, perioperative complication rate, hospitalization time, the incidence of major adverse cardiac events in 3 months and the levels of necrosis factor alpha (TNF-alpha), high sensitive C reactive protein (hs-CRP) at preoperative and postoperative 12 h, postoperative 3 d and 7d were observed and compared between two groups. Results The operation time,puncture to balloon opening time, X-ray exposure time, PCI rate, the incidence of reperfusion arrhythmias in two groups had no significant differences (P > 0.05). The incidences of perioperative complications and hospitalization time in radial artery group were significantly shorter than those in femoral artery group: 5.48%(4/73) vs. 28.77%(21/73), (7.83 ± 1.13) d vs.(9.74 ± 1.57) d, P<0.05. The levels of TNF-αand hs-CRP in two groups before operation had no significant difference (P>0.05). The levels of TNF-αand hs-CRP in two groups 12 h after operation were significant increased (P<0.05), and gradually decreased 3 d and 7 d after operation. The levels of TNF-αand hs-CRP in two groups had no significant differences (P>0.05). The incidence of major adverse cardiac events in 3 months in two groups had no significant difference (P>0.05). Conclusions Transradial approach by skilled physicians in the treatment of acute ST segment elevation myocardial infarction has the same safety and feasibility compared with femoral artery approach, and can reduce the incidence of postoperative complications and hospitalization time.It has a certain clinical advantages, and it is worthy of popularization and application.
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Objective To investigate the efficacy of transradial approach in the treatment of acute myocardial infarction (AMI) with direct coronary intervention and its influence on inflammatory factors. Methods One hundred and forty-six patients with acute ST elevation myocardial infarction were randomly divided into radial artery group and femoral artery group with 73 cases in each group. The patients in radial artery group received transradial percutaneous coronary intervention (PCI) by transradial approach, and those in the femoral artery group were treated with PCI by transfemoral approach. The operation time, puncture to balloon opening time, X-ray exposure time, contrast agent dosage, the success rate of PCI, reperfusion arrhythmia, perioperative complication rate, hospitalization time, the incidence of major adverse cardiac events in 3 months and the levels of necrosis factor alpha (TNF-alpha), high sensitive C reactive protein (hs-CRP) at preoperative and postoperative 12 h, postoperative 3 d and 7d were observed and compared between two groups. Results The operation time,puncture to balloon opening time, X-ray exposure time, PCI rate, the incidence of reperfusion arrhythmias in two groups had no significant differences (P > 0.05). The incidences of perioperative complications and hospitalization time in radial artery group were significantly shorter than those in femoral artery group: 5.48%(4/73) vs. 28.77%(21/73), (7.83 ± 1.13) d vs.(9.74 ± 1.57) d, P<0.05. The levels of TNF-αand hs-CRP in two groups before operation had no significant difference (P>0.05). The levels of TNF-αand hs-CRP in two groups 12 h after operation were significant increased (P<0.05), and gradually decreased 3 d and 7 d after operation. The levels of TNF-αand hs-CRP in two groups had no significant differences (P>0.05). The incidence of major adverse cardiac events in 3 months in two groups had no significant difference (P>0.05). Conclusions Transradial approach by skilled physicians in the treatment of acute ST segment elevation myocardial infarction has the same safety and feasibility compared with femoral artery approach, and can reduce the incidence of postoperative complications and hospitalization time.It has a certain clinical advantages, and it is worthy of popularization and application.
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Objective To observe the clinical effects and complications of coronary intervention through radial artery and femoral artery.Methods A hundred and sixty patients received coronary intervention treatment or coronary angiogram in the Second Affiliated Hospital of Bengbu Medical College from March 2010 to March 2015 were enrolled in this study.The patients were divided into radial artery puncture group (n =80),who received radial artery puncture and femoral artery puncture group (n =80) who received femoral artery puncture.The general date such as puncture time,intervention success rate,time in bed,postpuncture compression time and complications such as postoperative bleeding,arterial occlusion and postoperative untoward reactions were recorded and compared.Results The intervention success rate of radial artery puncture group was 90.0％ lower than that of femoral artery puncture group (97.5％),with statistically significant differences (P＜0.05).The puncture time,postpuncture compression time,time in bed and hospital stays of radial artery puncture group were significantly shorter than those of femoral artery puncture group (P ＜0.01).As for complications,the incidences of postpuncture bleeding and vagus nerve reflex in radial artery puncture group were significantly lower than that in femoral artery puncture group (P＜0.05).As for postoperative untoward reactions,the incidences of irritable and insomnia,uroschesis,pain caused by puncture,local skin injure,back pain in radial artery puncture group were significantly lower than those in femoral artery puncture group (P＜0.01).Conclusion With the advantages of mini-invasion,such as shorter time in bed and hospital stays,lower complications and untoward reactions rates,coronary intervention through radial artery is worth of clinical application.
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Background: The traditional methods of using anatomic landmarks to guide cannulation of the IJV have yielded various rates of successful access and complications. Moreover, central venous catheterization requires considerable expertise. Cannulation of the IJV was first described in 1969. Various positions were used to access cannulation but they were frequently associated with complications such as arterial puncture, pneumothorax, neurological damage, infection, dysrhythmias, atrial thrombus, cardiac rupture. Methods: Thirty critical care patients were selected for IJV cannulation either by Land mark technique. This study conducted in department of anaesthesiology and critical care, M. S. Ramaiah medical college, Bangalore. India. Results: In our study there was 83.3% success in LMG technique. The mean access time was 323.23 ± 146.19 sec and the distribution of complications encountered during the study, Carotid artery was accidentally punctured in 1 (3.3%) cases. In LMG technique, there were no cases of arrhythmias, haematoma, pneumothorax, haemothorax, nerve injury and catheter malposition were noted during the study. Conclusion: Land mark technique catheterization of internal jugular vein was shown complications than newly developed ultrasound guided method.
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Objective To study the influence of the early ambulation on postoperative patients' comfort and complications with the femoral artery puncture interventional therapy.Methods After searching for related literatures with computer,we evaluated the quality of the literatures and screened them.12 random controlled trials met the inclusion criterion.Using RevMan 5.1.2 software,we respectively made Meta analysis for patients with sense of comfort and complications after operations.Results Compared with the control groups,the experimental groups were better in back pain,abdominal pain,limb numbness and acid bilges,sleep disorder,dysuria and urinary retention than those of the control groups.And the difference in the site of puncture bleeding and hematoma had no statistical significance between the two groups.Conclusions It can improve comfort for patients without increasing incidence rate of complications by lying in bed and rest for 12 hours after interventional therapy.It reflects the patient-centered nurs-ing service concept and can improve the patients' quality of life.
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Objective To explore the effect of 3M Tegaderm transparent film on prevention of puncture complications in patients underwent aortocranial angiography via the femoral artery.Methods A retrospective analysis was carried out on 200 patients underwent aortocranial angiography via the femoral artery from February 2012 to February 2014.Eighty patients without using the transparent dressing paste were as the control group,and other 120 patients using 3M Tegaderm transparent film for fixation of arterial sheath were as the observation group.The occurrences of complications,such as arterial sheath breakage,angiographic tube breakage,femoral artery spasm,bruises at the puncture site and subcutaneous hematoma were analyzed,and the feasibility and effectiveness of 3M Tegaderm transparent film for fixation of arterial sheath were assessed.Results The incidence rate of arterial sheath breakage,angiographic tube breakage,femoral artery spasm,bruises at the puncture site and subcutaneous hematoma were significantly reduced in observation group compared with those in control group [5.8％ (7/120) vs.26.2％ (21/80)] (P ＜ 0.05).Conclusion Application of 3M Tegaderm transparent film with a low price and good security for fixation of femoral artery sheath can effectively reduce the occurrence of complications related to femoral artery puncture,which is worthy of wide spreading.
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Objective To discuss the application of prospective risk nursing measures in reducing the occurrence of postoperative local hematoma at femoral artery puncture site. Methods A total of 605 patients receiving femoral artery puncture for interventional management were collected as the control group , and 322 patients were used as the intervention group. The risk factors causing postoperative local hematoma at femoral artery puncture site in the control group were recorded, and based on which risk estimation survey table was designed. According to risk estimation survey, the prospective intervention measures, including risk assessment, standardization of professional training, individual health education, the improvement of care appliance, etc. were carried out for the patients of the intervention group. The occurrences of postoperative local hematoma at femoral artery puncture site were recorded and the results were compared between the two groups. Results No statistically significant differences in demographic and clinical data existed between the two groups. However, the incidence of hematoma in the intervention group was significantly lower than that in the control group (χ2 = 4.652, P < 0.05), although the difference in the severity of hematoma was not significant between the two groups. Conclusion The use of prospective risk nursing measures can effectively reduce the incidence of postoperative hematoma at femoral artery puncture site.
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Objective To study the effect of whole-process nursing intervention on comfort of patients undergoing radial artery puncture. Methods 100 patients with radial artery puncture from July, 2007 to June, 2008 were divided into the control group and the experimental group with 50 cases in each group accord-ing to time sequence. Routine whole nursing mode was used in the control group, the whole-process nursing intervention mode based upon routine nursing mode under the instruction of evidence-based method was used in the experimental group. Pain, psychological tensity, body numbness, success rate of radial artery puncture, patients' satisfaction degree were compared between the two groups. Results Every indexes of the experi-mental group were better than those of the control group. Conclusions The whole-process nursing interven-tion mode can promote the comfort degree of patients undergoing radial artery puncture.
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Objective To study the hemostnsis effects of compression cords oppressing after femoral artery puncture and encheiresis. Methods Self-made compression cords were used to stop bleeding of femoral artery puncture sites in 2164 patients underwent 3046 cases of arteriopuncture encheiresis. The total eases were divided into group A (1482 eases) and group B (1564 cases) according to different treatment of oppression and breaking duration which were 8-10 hours for group A and 5-6 hours for group B, the hemostasis effects, discomfortableness and related complications within two groups were evaluated. Results The proportion of patients who got good hemostasis effects were 99.2% in group A, 99.0% in group B. There was no difference in hemostasis effects between two groups (P> 0.05). While the rate of discomfortableness in group A (63.8%) was higher than that in group B(42.9%) (P<0.05). The related serious complications were 2 patients in group A, but no occurred in group B. Conclusion Self-made compression cords op- pressing and 5-6 hours breaking time course can achieve both finer hemostasis effect and lower frequency of complications after femoral artery puncture and encheiresis.
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No definitive etiology or risk factors have been identified that predispose individuals to developing complex regional pain syndrome (CRPS). We experienced two cases of CRPS developed after arterial and venous puncture which were done in regular medical work. A 35-years old female patient was suffered from pain and allodynia with swelling at right hand and wrist after radial artery puncture for monitoring of blood pressure during general anesthesia. A 24-years old male patient had pain and swelling with allodynia at the right fingers and arm after median cubital vein puncture for blood sampling. They did not have proper pain management as CRPS patients in the past weeks and months after their pain occurred. They were diagnosed as CRPS and started undergoing various interventional procedures, which led to improve their pain condition. Our cases suggest that CRPS could develop without any proved tissue damage in routine medical practice. In conclusion, health care workers should be educated in knowledge about the uncommon medical condition and proper consultation to pain specialist when it happens.
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Adult , Female , Humans , Male , Young Adult , Anesthesia, General , Arm , Arteries , Blood Pressure , Delivery of Health Care , Fingers , Hand , Hyperalgesia , Pain Management , Punctures , Radial Artery , Risk Factors , Specialization , Veins , WristABSTRACT
Objective To study the proper method of hamotasis by compression after femoral artery puncture for hemodialysis patients, and then decline the incidence rate of complication. Methods There were 107 hemodialysis patients in the observation group and 106 patients were in the control group. The method of using hard board paper press the point of puncture was adopted in the observation group, the traditional method was used in the control group. Compare the incidence rate of complication and the braking time after the puncture in the two groups. Results The incidence rate of complication in the control group was significant higher than that of in the observation group, P
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ObjectiveTo explore whether the posture changing can ameliorate the dysuria for patients with femoral artery puncture and catheterization, and observe the influence of posture changing on blooding in the point of puncture. Methods Changing patients′ posture under the order of nurses, and then observed the amelioration condition of dysuria. Results After using intervention method, the rate of urinary stasis decreased from 31.67% to 4.17%, the rate of using urethral catheterization also decreased from 8.33% to 1.67%. Conclusion Posture changing was an effective method to ameliorate the dysuria for patients with femoral artery puncture and catheterization.
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BACKGROUND: Invasive central venous catheterization is necessary in critically ill patients for hemodynamic monitoring and for administration of hypertonic fluids, drugs, and parenteral nutrition. Common access sites are the internal jugular veins, subclavian veins, and femoral veins. Yoffa's percutaneous supraclavicular subclavian vein catheterization technique has some disadvantages and difficulties which include dislodgement of the puncture needle and difficult enhancement of the guide wire. To overcome these problems, we modified Yoffa's technique as a symmetrical puncture against the clavicle. METHODS: A patient was placed supine with his/her head turned to the opposite side with the arm at the side. The needle was inserted through the skin at a point around 1 cm below the clavicle, toward the imaginary midline of the clavicular head of the sternocleidomastoid muscle (SCM). The guide wire was inserted with a J-wire. Measurements were made to determine the length from the puncture site to the lower border of the clavicle, the depth and angles from the needle to mid sagittal line, the coronary line and skin (Fig. 2). We also evaluated the No. of punctures, wire insertions, and complications. RESULTS: Our success rate was 95.1% and 6 cases with complications (5.9%) occurred in 102 attempts. The most serious complication was a delayed tension pneumothorax 6 h postoperatively. CONCLUSIONS: These results suggest that the new landmark for infraclavicular subclavian vein catheterization is an easy and safe procedure for an experienced physician. We also recommend close observation postoperatively for at least 24 h for complications.