Safety of Venipuncture Sites at the Cubital Fossa as Assessed by Ultrasonography.
Safety of Venipuncture Sites at the Cubital Fossa as Assessed by Ultrasonography.
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DOI：
10.1097/pts.0000000000000441
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发表时间：
2020-03
影响因子：
2.2
通讯作者：
Nakatani T
中科院分区：
文献类型：
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作者：
Mukai K;Nakajima Y;Nakano T;Okuhira M;Kasashima A;Hayashi R;Yamashita M;Urai T;Nakatani T
本观察性研究的目的是通过超声测量止血带应用前后各浅表静脉的深度和截面积，以及各浅表静脉与正中神经或肱动脉的距离，确定临床护理中安全、合适的静脉穿刺部位。招募健康志愿者20名（21.8 [0.6]y）。止血带应用前后各浅表静脉可见率：basilic静脉65%，肘中静脉90% ~ 95%，头静脉65% ~ 80%。止血带应用后肘正中静脉的横截面积明显大于基底静脉和头静脉。基底静脉或肘正中静脉与正中神经的距离明显小于头静脉与正中神经的距离。基底静脉或肘正中静脉与肱动脉的距离明显小于头静脉与肱动脉的距离。这些结果表明，由于肘窝头静脉离正中神经和肱动脉较远，是一个相对安全的静脉穿刺点。当头静脉因不可见而穿刺困难时，可选择肘窝的肘正中静脉，因其横截面积大，可见性好；然而，由于正中神经和肱动脉位于下方，需要小心避免刺穿静脉。
The aim of the present observational study was to identify safe and suitable venipuncture sites for nursing in the clinical setting using ultrasonography to measure the depth and cross-sectional area of each superficial vein before and after tourniquet application as well as the distance between each superficial vein and the median nerve or brachial artery. Twenty healthy volunteers (21.8 [0.6] y) were recruited. The visible rate of each superficial vein before and after tourniquet application was 65% for the basilic vein, 90% to 95% for the median cubital vein, and 65% to 80% for the cephalic vein. The cross-sectional area of the median cubital vein after tourniquet application was significantly larger than that of the basilic vein and cephalic vein. The distance between the basilic vein or median cubital vein and median nerve was significantly smaller than that between the cephalic vein and median nerve. The distance between the basilic vein or median cubital vein and brachial artery was significantly smaller than that between the cephalic vein and brachial artery. These results demonstrated that the cephalic vein at the cubital fossa is a relatively safe venipuncture site because of its distance from the median nerve and brachial artery. When puncturing the cephalic vein is difficult because it is not visible, the median cubital vein at the cubital fossa may be selected for venipuncture due to its cross-sectional area and visibility; however, care is needed to avoid penetrating the vein because the median nerve and brachial artery are located underneath.