超声检查体位对穿刺颈内静脉位置的影响  

Influence of ultrasonography position on internal jugular puncture in ultrasonic examination

作　　者：邢金城[1] 赵茗姝[1] 高宝柱[1] 

机构地区：[1]天津市第三中心医院麻醉科,天津300170

出　　处：《生物医学工程与临床》2012年第4期363-364,共2页Biomedical Engineering and Clinical Medicine

摘　　要：目的应用超声技术,观察不同体位双侧颈总动脉、颈内静脉相对位置的变化,以选择临床血管穿刺的最佳体位,提高操作成功率。方法择期全身麻醉患者40例,其中男性22例,女性18例;年龄35～59岁,平均年龄48岁。分别于平卧位及头低30°体位,保持头正中位(0°),应用超声在左右两侧高、中、低位探测颈总动脉、颈内静脉血管内径及重叠程度。结果与平卧位比较,头低30°体位时的左颈部中位[(7.9±1.7)mm vs(7.0±0.7)mm],右颈部高位、中位[(8.4±1.7)mm、(8.2±1.9)mmvs(7.2±0.7)mm、(7.3±0.6)mm]的颈总动脉内径增大,双侧颈部高、中、低位的颈内静脉内径均增大[左侧(13.1±2.9)mm、(13.3±3.1)mm、(12.9±3.2)mm vs(11.2±1.5)mm、(11.3±2.4)mm、(11.3±2.0)mm,右侧(12.9±3.0)mm、(12.8±4.0)mm、(12.8±4.5)mm vs(10.8±1.4)mm、(11.4±3.2)mn、(11.0±2.5)mm](P<0.05)。结论采用头低30°体位,颈内静脉内径增大,但颈总动脉与颈内静脉重叠程度无改变。Objective To observe the difference of bilateral carotid artery and internal jugular relative position in different postures by ultrasonic technology, and confirm the optimal posture and improve the operation success rate. Methods A total of 40 patients undergoing elective general anesthesia were enrolled, male 22, female 18, aged 35 - 59 years old, mean age 48 years old. In supine position and head down 30° position, respectively, kept head median（0°）, used ultrasonic technology, in the high, medium, low point explored the internal diameter and the degree of overlap in bilateral carotid artery and internal jugular. Results Compared with supine position, in head down 30~ position, the internal diameter of carotid artery of left side medium point[（7.9 ± 1.7） mm vs （7.0 ± 0.7） mm], the fight side high and medium point [（8.4 ± 1.7） mm, （8.2 ± 1.9） mm vs （7.2 ± 0.7） mm, （7.3 ± 0.6） mm] were increased, the internal diameter of internal jugular of both sides high, medium and low points were all increased[left side （13.1 ± 2.9） mm, （13.3 ± 3.1） mm,（12.9 ± 3.2） mm vs （12.1 ± 1.5） mrn, （11.3 ±2.4） mm, （11.3 ± 2.0） mm, right side （12.9 ± 3.0） mm, （12.8 ±4.0） mm, （12.8 ± 4.5） mm vs （10.8± 1.4） mm, （11.4 ± 3.2） mm, （11.0 ±2.5） mm]（P〈 0.05）. Conclusion It is demonstrated that in head down 30° position, the internal d- iameter of internal jugular is increased, the degree of overlap in carotid artery and internal jugular have no change. Ultrasonic technology could improve the internal jugular puncture success rate, and reduce complications.

关 键 词：超声引导 颈内静脉穿刺 置管术 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.4[医药卫生—诊断学]