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目的:探讨超声引导下导引结合自由手穿刺技术在胎儿脐静脉穿刺的实用性。方法:对1 032例有脐静脉穿刺指征的孕妇实施超声引导下导引结合自由手脐静脉穿刺,记录穿刺成功率、完成时间及并发症发生情况。结果:一次穿刺成功率98.38%,两次穿刺成功率100.00%;58%的患者在1 min内完成,87.70%的患者在2 min内完成,94.80%的患者在5 min内完成。胎儿心率发生变化者占4.17%;无感染、羊水栓塞、胎盘早剥、胎膜早破、死胎发生。结论:超声引导下导引结合自由手穿刺技术较超声引导下导引或超声引导下自由手穿刺技术行胎儿脐静脉穿刺成功率高、时间短、并发症少,是一种安全高效的经腹胎儿脐静脉穿刺方法。
Objective: To explore the practicality of ultrasound-guided guided umbilical vein puncture combined with free-hand puncture technique. Methods: A total of 1032 pregnant women with indications of umbilical venipuncture were guided by ultrasound guidance and combined with free hand umbilical venipuncture. The successful rate, completion time and complication were recorded. Results: The successful rate of primary puncture was 98.38% and the successful rate of puncture was 100.00%. 58% of patients completed within 1 minute, 87.70% of patients completed within 2 minutes and 94.80% of patients completed within 5 minutes. Fetal heart rate changes accounted for 4.17%; no infection, amniotic fluid embolism, placental abruption, premature rupture of membranes, stillbirth. Conclusions: Ultrasound-guided and free-hand puncture technique is a safe and effective transabdominal method with high success rate, short time and fewer complications compared with guided by ultrasound or guided by ultrasound. Fetal umbilical vein puncture method.