魏桂花　黄健　谢小花

[摘要] 目的 探讨四肢浅静脉逆行性静脉穿刺在临床中的应用效果。 方法 选择2013年1～12月间普外科60例长期静脉输液的老年患者，随机分为试验组30例和对照组30例。试验组采取逆行性静脉穿刺，对照组采取传统的向心性静脉穿刺，比较两组的一次穿刺成功率、局部渗出及肿胀例数、液体滴数、活动受限例数。结果 试验组一次性穿刺成功率明显高于对照组（P<0.05），两种穿刺方法对同种液体流速无显著影响，试验组局部渗出及肿胀、活动受限的发生低于对照组，差异有统计学意义（P<0.05）。 结论 逆行性静脉穿刺可提高四肢浅静脉的利用率，穿刺成功率高，减少患者的疼痛及减轻高渗药物对血管的损伤，提高护士的工作效率，提高护理质量，增加患者的舒适度及满意度。

[关键词] 四肢；浅静脉；逆行；静脉穿刺；护理

[中图分类号] R472 [文献标识码] B [文章编号] 1673-9701（2015）04-0152-03

[Abstract] Objective To explore the application effect of limb superficial vein retrograde venipuncture in clinic. Methods 60 general surgery elderly patients of long-term intravenous infusion from January 2013 to Deceber 2013 were divided randomly into two groups， experimental group and control group， with 30 in each group. Experimental group received retrograde venipuncture. Control group received traditional centripetal venipuncture. One time puncture success rate， number of local exudationand swelling cases， liquid droplet number， the number of cases of restricted activity were compared between the two groups. Results One time puncture success rate of experimental group was higher than that of control group（P<0.05）. The two puncture methods had no significant effect on the same liquid velocity. Local exudation and swelling， limitation of activity of experimental group occurred less than that of the control group， the difference had statistical significance（P<0.05）. Conclusion Retrograde venipuncture can improve the limbs superficial vein puncture success rate and the utilization rate， reduce the pain of patients and reduce injury of hyperosmotic drugs on the blood vessel. It improves nurses' work efficiency， improve nursing quality， increases patients comfort and satisfaction.

[Key words] The limbs； Superficial vein； Retrograde； Venipuncture； Nursing

静脉输液是广泛应用于临床中防治疾病及抢救危重患者的重要给药途径，也是护理常规基本的技能操作。临床上常规采取向心性静脉穿刺，但是对于长期静脉输液、反复静脉穿刺和长期输入刺激性药物的患者及血管条件差的老年患者，使用向心性静脉穿刺常导致药物渗出组织间隙中，出现局部肿胀，并且长期药物刺激会使血管发生条索样改变，进而出现血管易滑动、血管细、脆性大、不易固定，导致浅静脉严重破坏，导致患者畏惧静脉输液，降低了静脉输液的依从性，使常规向心性静脉穿刺很难一次性成功。随着现代医学、护理模式的转变以及人们对护理工作要求的提高，以人为本的人文关怀也在不断渗透到护理工作中，在不影响治疗和护理效果的前提下，更强调护理操作应尽量减少患者的疼痛，增加舒适感[1]。受小儿头皮静脉穿刺启示[2]，临床上采用四肢远端浅静脉逆行性穿刺方法，临床效果显著，现报道如下。……