以雙導管法施行臍動脈導管術之經驗

Clinical Experience of Umbilical Arterial Catheterization with Double-Catheter Technique

陳忠誠(Chung-Cheng Chen) ； 黃富源(Fu-Yuan Huang) ； 林炫沛(Shuan-Per Lin) ； 杜松壽(Sung-Shou Tu)

《Acta Paediatrica Sinica》 28卷4期 (1987/08) Pp. 224-227

摘要

為了克服傳統式單一支臍導管方向錯誤時的置放困難，假想以燒道(bypass)技衍－當第1支臍導管誤入內腸骨動脈或外腸骨動脈的分枝，不能經由總片骨動脈到達下行主動脈預定位置時（圖2），仍維持在遇到阻力的位置，立即在這同一臍動脈腔內插入同號大小的第2支臍導管，反而放置成功。玆提出在新生兒加護病房，對11 例病嬰，遇到單一支臍導管方向錯誤因而放置失敗，採用此種變導管繞道技術，其中8例放置成功, 2例失敗， 1例則應用三導管技術放置成功，全無併發症發生。因此，雙導管技術，可作為解決單一支臍導管方向錯誤時的良方，但需把握要領，手法輕巧，以防併發症產生。

並列摘要

Umbilical arterial catheterization for blood gas monitoring is very important in the management of the high risk neonates. A single umbilical arterial catheter may occasionally be misdirected into the branch of internal iliac artery or external iliac artery. When a single umbilical arterial catheterization is not successful, the first umbilical arterial catheter is left at the misdirected position, the second catheter then inserted and bypasses the troublesome branch to enter the aorta. We have experienced 11 cases of a single catheter with misdirection. The double-catheter technique has allowed us to overcome the problem of a misdirected catheter in 8 cases. It failed in 3 cases. However, this technique should be-used carefully and should be abandoned if there is resistance to insertion of the second catheter in the same umbilical arterial lumen.

並列關鍵字

umbilical arterial catheterization ； double-catheter technique