末梢静脈内カテーテル留置法では,対象静脈が目視困難な場合,確実な穿刺,合併症の発生 に影響を及ぼす.本研究の目的は目視困難静脈の穿刺技術向上に向け,目視の可否による血管 径・深さ,動脈との位置関係を超音波診断装置で,皮膚色を色差計で計測し違いを明らかにす ることである.研究デザインは実態調査型研究である.対象者は健常若年女性 20 名,計測静 脈は 58 本,計測動脈は 18 本であった.その結果,目視の可否に有意差があったのは深さの みで,血管径,動脈との位置関係,皮膚色は同等であることが明らかになった.静脈の深さの 平均(SD)は,目視可能静脈が 2.7(0.7)mm,目視困難静脈が 4.6(1.8)mm であっ た(p=.0001) .目視の可否の分離値は 3.0mm(AUC=0.919, 95% CI 0.84 -0.99) で,深さ3mm 以上の留置カテーテル用末梢静脈は目視困難になることが明らかとなった.し たがって,目視困難な静脈は深さ3mm 以上の穿刺技術が,動脈穿刺の防止は,目視の可否に 関わらない穿刺技術の必要性が示唆された.

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... 置,可視性 During catheter placement, peripheral intravenous access is affected by the visibility of the vein, such that the risk of peripheral nerve injuries and arterial punctures, increases as the visibility decreases. This study examined the relation between vein visibility and (a) vein width, (b) vein depth, (c) position of the artery relative to the vein, and (d) skin color. This was an observational study with prospective data collection. A total of 20 healthy young women (58 veins and 18 arteries) were examined. As a result, vein visibility demonstrated significant differences in relation to vein depth, but not in relation to the other three factors. The mean depth (SD) was 2.7 (0.7) mm for visible veins and 4.6 (1.8) mm for invisible veins (p=0.0001) . The cut off point was 3.0 mm (AUC=0.919 95% CI-0.84 to 0.99) , indicating that peripheral veins for catheter placement are more likely to be invisible when the depth is 3.0 mm or more. These findings highlight the need for two kinds of venipuncture skills: those for invisible veins with a depth of 3.0 mm or more, and those that will prevent arterial puncture regardless of vein visibility.