超声下右侧颈内静脉与颈总动脉间解剖关系的研究  

Anatomic Relationship between Right Internal Jugular Vein and Common Carotid:an Ultrasound Study in Clinic

作　　者：陆利冲[1] 汪小海[1] 李浩[2] 郑曼[2] 

机构地区：[1]南京医科大学附属鼓楼临床医院麻醉科,210008 [2]南京大学医学院附属鼓楼医院麻醉科

出　　处：《医学研究杂志》2010年第11期111-113,共3页Journal of Medical Research

摘　　要：目的右侧颈内静脉穿刺置管术作为深静脉穿刺的首选在临床广泛应用,其误伤动脉的并发症较高。本研究的目的是利用超声技术探讨右侧颈内静脉与颈总动脉间解剖关系的变化特点。方法记录139名成年患者右颈部高位(胸锁乳突肌上乳头突起至锁骨中点)、中位(胸锁乳突肌的胸骨段与锁骨段的交叉点)、低位(胸锁乳突肌胸骨头靠近锁骨区域)3处位置上的动颈内静脉深度、动静脉体表相对距离、静脉夹角及重叠距离。结果与高位相比,中位和低位的静脉深度、动静脉体表相对距离和动静脉夹角均显著减小,重叠覆盖程度则显著增大。与中位相比,低位的静脉深度、动静脉体表相对距离和动静脉夹角也均显著减小,重叠覆盖程度显著增大。结论高位处颈内静脉变异较小,临床上用解剖定位法在该处行右侧颈内静脉穿刺成功率较高,动脉损伤概率小。Objective Right internal jugular vein （IJV） is a common vessel to obtain venous access in clinic. To avoid inadvertent arterial puncture, it should be important to have a clear understanding in the anatomic relationship between the right IJV and the common carotid arteries （CCA）. This study aims to objectively evaluate the anatomic relationship between right IJV and CCA. Methods 139 adult patients were selected at random and their right IJV and CCA were investigated at three points （high, middle, and low points） by portable ultrasonography. These indexes were observed： the depth of IJV under the skin （hereinafter referred to as depth） , relative dis- tance of IJV to CCA （as distance）, the angle of IJV facing CCA （as angle） and the degree of overlapping of the IJV and CCA （as over- lapping）. Results The depth, distance and angle were significantly decreased and the overlapping was significantly increased at the mid- dle and low points compared to high point. The distance and angle were significantly decreased and the overlapping was significantly increased at the low points compared to middle point. Conclusion The anatomic feature of the IJV showes that IJV puncture at high point is advisable to improve the success rate and reduce CCA injury.

关 键 词：超声 颈内静脉 颈总动脉 颈部血管解剖 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]