锁骨中点定位腋静脉穿刺术的临床应用  

Clinical application of axillary venipuncture locating at the clavicle midpoint

作　　者：李建国[1] 郭志强[1] 孟令宝[1] 杨文珍[1] 鲍勇[1] 张景[1] 

机构地区：[1]华北油田总医院ICU,河北062552

出　　处：《中国急救复苏与灾害医学杂志》2010年第9期854-855,共2页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨以锁骨中点定位的腋静脉穿刺置管安全性及临床应用价值。方法根据100例正常成人腋静脉的超声影像，以锁骨中点定位腋静脉的标志点，以此标志点穿刺，在危重患者建立静脉通路87例。结果本组一针成功61例（70．1％），二针22例（25．3％），三针以上4例（4．6％），操作成功84例（96．6％），操作失败3例（3．3％）。并发症发生情况：局部感染3例（3．4％），全身感染1例（1．1％），穿刺点皮下血肿1例（1．1％），穿刺点皮下液肿1例（1．1％），无气胸。未发生空气栓塞、恶性心律失常等严重并发症。结论以锁骨中点定位的腋静脉穿刺置管，操作容易、成功率高、并发症少，值得在临床推广应用。Objective To evaluate the safety and clinical outcome of axillary venipuncture locating at clavicle midpoint. Methods Locating at the clavicle midpoint as the sign of the axillary vein with the reference of the axillary vein uhrasonography obtained from 100 healthy adults, the venous access was established on 87 critically ill patients by the punctuating at the sign. Results It ends up with 61 cases of one-time punctuation, 70.1%, 22 cases of double punctuations, 25.3%, four eases of triple or more punctuations , 4.6%. Out of the 87 operations, 84 of them, 96.6%, were considered being successful while the rest three, 3.3%, were failed. The complications were seen as follows-three eases of local infection, 3.4%, one case of systemie infection, 1.1%, one case of punctuating site hematoma 1.1%, one case of subcutaneous fluid swelling in punctuating site, 1.1%. No pneumothorax was found, nor air embolism, arrhythmia, and other serious complications. Conclusion The method of axillary venipuncture locating at the clavicle midpoint carries the features of easy operation, high successful rate, few complications, which suggest it being utilized in clinical application.

关 键 词：腋静脉 穿刺 并发症 锁骨中点 

分 类 号：R459.7[医药卫生—急诊医学]