三部位深静脉置管术的临床研究  

Study:3 locations of central venous catheterization

作　　者：陈瑞丰[1] 王立秋[1] 黄立嵩[1] 

机构地区：[1]海军总医院急诊科,北京100048

出　　处：《临床急诊杂志》2012年第2期86-88,共3页Journal of Clinical Emergency

摘　　要：目的:探讨锁骨下、颈内及股静脉3部位深静脉置管术主要并发症及置管的难易程度。方法:选取600例患者,随机分为锁骨下静脉(A)、颈内静脉(B)和股静脉(C)组,比较3组的穿刺成功率及主要并发症指标,明确3部位穿刺技术的优缺点。结果:一次性成功率以锁骨下静脉最低,股静脉最高,3者比较P<0.05;但总体成功率P>0.05。锁穿发生导管易位率最高,P<0.05,但与颈内静脉对比在其他并发症上无明显差异,P>0.05;股静脉置管虽在导管易位及气胸方面有优势,但其他并发症均高于前二者,P<0.05。结论:三部位置管术各有优缺点,操作者应根据患者情况及自身经验合理选择,尽量降低并发症的发生率,良好的解剖学知识及丰富的置管经验是深静脉置管的必须条件。Objective：To investigate the complications and operation difficulties of central venous catheterization（CVC） in three respective locations.Method：600 cases were randomly divided into three groups with each group of 200,who required central venous catheterization,the subclavian vein group（group A）,the internal jugular vein group（group B） and the femoral vein group（group C）.Compare the complications and operation difficulties of the three groups.Result：Compare the three groups,the once puncture achievement ratio of group A was the lowest and group C was the highest.The results of the three group had contrast（P0.05）.While the general puncture achievement ratio had no different（P0.05）.Group A had the highest opportunity for catheter malposition ratio（P0.05）,but had similar complications compared with group B（P0.05）.Group C had advantages on preventing catheter malposition and pneumothorax,while it had higher opportunity for the other complications（P0.05）.Conclusion：There is respective advantages and defects on the three locations for CVC.The safe and successful performance of a CVC requires s specific knowledge of amntomy in addition to a working knowledge.

关 键 词：中心静脉置管术 锁骨下静脉 颈内静脉 股静脉 并发症 

分 类 号：R45[医药卫生—治疗学]