三中点法建立锁骨下静脉通路621例  

Three-midpoint method to establish subclavian vein access in 621 patients

作　　者：果应菲[1] 王建国[2] 何忠杰[1] 张宪[1] 马俊勋[1] 宋祖军[3] 

机构地区：[1]解放军总医院304急救部,北京100037 [2]西安市中心医院心血管内科,陕西西安710003 [3]第四军医大学西京医院急诊中心,陕西西安710033

出　　处：《第四军医大学学报》2005年第19期1781-1783,共3页Journal of the Fourth Military Medical University

摘　　要：目的:探讨在急诊抢救危重患者时建立锁骨下静脉通路方法.方法:1995-02/2004-12使用三中点法建立锁骨下静脉通路621例.结果:本组患者一针成功399例(64.3%),二针159例(25.6%),三针以上63例(10.1%),操作成功617例(99.4%),操作失败4例(0.6%).在非标准体位下锁骨下行静脉穿刺术38例1次穿刺成功22例,成功率57.9%,低于标准体位的64.3%.并发症发生情况:局部感染25例(4.0%),全身感染5例(0.8%),穿刺点皮下血肿12例(1.9%),穿刺点皮下液肿4例(0.6%),气胸4例(0.6%).未发生空气栓塞、恶性心律失常等严重并发症.结论:三中点法建立锁骨下静脉通路是急诊危重患者抢救时值得推荐的静脉通路建立方法.AIM： To discuss the method of subclavian vein puncture in the emergency management. METHODS： Three-midpoint method of establishing subclavian vein access was used in 621 emergency cases between February 1995 to December 2004, RESULTS： One pricker was achieved in 399 cases, two prickers in 159 cases and three prickers in 63 cases. The subclavian vein access was successfully established totally in 617 cases and failed in 4 cases. One pricker in non-standard pose was achieved in 22 cases of the 38 cases （57. 9%）, lower than that in standard pose （64.3%）. Local infection was found in 25 cases, general infection in 5 cases, local subcutaneous haematoma in 12 cases, local subcutaneous liquid turges- cence in 4 cases and pneumothorax in 4 cases. No serious complications were observed. CONCLUSION： The three midpoint method of establishing subclavian vein access is recommended in emergency management.

关 键 词：锁骨下静脉穿刺 中心静脉置管 三中点法 

分 类 号：R63[医药卫生—外科学]