Application of ultrasound guidance in patients with difficulty in intravenous indwelling needle puncture during contrast-enhanced computed tomography

Abstract:

Objective：To investigate the feasibility and operating points of ultrasound guidance in indwelling needle puncture in pa－tients with difficulty in venipuncture during contrast-enhanced computed tomography（CT）. Methods：A total of 46 patients with poor vascular conditions were enrolled as control group and were given venipuncture with the conventional indwelling needle puncture method，and 43 patients with failed venipuncture were enrolled as experimental group and were given ultrasound-guided venipunc－ture. The chi-square test was used to compare puncture success rate and complications between two groups，and the paired samples t-test was used to compare the time spent on vessel selection，number of times of puncture，and number of times of needle insertion between two groups. Results：Three patients in the control group had successful puncture，while all 43 patients in the experimental group had successful puncture under ultrasound guidance，among whom 38 had successful one-time puncture and 5 had successful puncture after two times of puncture，resulting in a puncture success rate of 100%. There were significant differences between the ex－perimental group and the control group in the success rate of one-time puncture（ χ2=70.940，P=0.000） and overall success rate（ χ2= 77.770，P=0.000），and the experimental group had a significantly lower incidence rate of complications than the control group（ χ2= 15.151，P=0.000）. Compared with the control group，the experimental group had significantly shorter time spent on vessel selection （3.65±1.571 vs. 36.86±7.11，t=32.412，P<0.01） and significantly lower numbers of times of puncture（1.12±0.32 vs. 3.56±0.50，t=31.866，P<0.01） and needle insertion（1.21±0.47 vs. 7.56±1.65，t=23.685，P<0.01）. Conclusion：In patients with difficulty in venipuncture，ultrasound-guided indwelling needle puncture can improve puncture success rate，alleviate pain，and help them to undergo a successful CT examination. The operation is simple and safe，thus holding promise for clinical application.