浅表超声观察右颈内静脉与颈总动脉的解剖关系及影响因素  

Ultrasonic study on anatomic relationship between right internal jugular vein and common carotid artery and its influential factors

作　　者：陆利冲[1] 汪小海[1] 李浩[1] 郑曼[1] 

机构地区：[1]南京大学医学院附属鼓楼医院麻醉科,210008

出　　处：《临床麻醉学杂志》2011年第11期1083-1085,共3页Journal of Clinical Anesthesiology

摘　　要：目的利用超声技术探讨右侧颈内静脉与颈总动脉间的解剖关系以及影响因素。方法随机选择306例成年患者,男171例,女135例,年龄18～86岁,BMI16～36kg/m2。超声探测右颈部高位(甲状软骨上缘水平)、中位(环状软骨水平)和低位(环状软骨水平下至2cm)三处位点颈内静脉与颈总动脉覆盖情况。比较不同性别、年龄及BMI的患者高、中、低位颈内静脉与颈总动脉覆盖情况差异。结果中、低位未覆盖率明显低于高位(P<0.05),而部分覆盖、完全覆盖率明显高于高位(P<0.05)。女性中位未覆盖率明显低于男性(P<0.05)。≥60岁患者低位未覆盖率明显低于其他年龄患者(P<0.05),完全覆盖率明显高于其他年龄患者(P<0.05)。BMI≥25kg/m2患者中、低位未覆盖率明显降低(P<0.05),而完全覆盖率明显升高(P<0.05)。影响覆盖程度的因素依次为:位点>BMI>性别>年龄,判别符合率为71.24%。结论高位右颈内静脉与颈总动脉覆盖程度低,行静脉穿刺时能减少损伤动脉概率。Objective To evaluate the anatomic relationship between the right internal jugular vein （IJV） and the common carotid artery （CCA） and its influential factors with ultrasonography. Methods Three hundred and six adult patients（171 males and 135 females, aged 18-86 yr, BMI ranged 16-36 kg/m^2 ）were randomly selected. The overlapping conditions between right ]JV and CCA were investigated with a portable ultrasonograph at three cross-section sites （high point： the upper border of thyroid cartilage; middle point： the cricoid cartilage level; low point： 2 cm below cricoid cartilage） and were compared between each section, different genders, ages and BMIs. Results The incidence of non-overlap was lower while the incidence of partial and complete overlaps was higher at the middle and the low points compared to the high point （P〈0. 05）. The incidence of non-overlap was lower at the middle point in male than in female （P〈0. 05）. The incidence of non-overlap at the low point was lower while the incidence of Complete overlap at the high point was higher in patients 60 yr than in other ages （P〈0.05）. The incidence of non-overlap was decreased while the incidence of complete overlap was increased at the middle and low points in patients with BMI≤25 kg/m2 （P〈 0. 05）. The impact of factors which influence the overlapping conditions followed in deseending order from site, BM1, gender to age, with a diseriminant coincidence rate of 71.24%. Conclusion Right IJV at the high point has a lower incidence of overlap with CCA and venous puncture at this point may reduce artery injury.

关 键 词：超声定位 右颈内静脉 颈总动脉 解剖 

分 类 号：R445.1[医药卫生—影像医学与核医学]