高龄患者锁骨下静脉位置的解剖学差异  

Anatomic Difference of Subclavian Vein for Old Patients

作　　者：史云恒[1] 吴文娟[1] 李志华[2] 刘向东[1] 吴慧钊[1] Abhinav Kumar Seemon Petrus Christopasak 

机构地区：[1]河北医学院第三医院放射科,石家庄050051 [2]河北医学院第三医院麻醉科,石家庄050051

出　　处：《临床放射学杂志》2012年第12期1755-1757,共3页Journal of Clinical Radiology

摘　　要：目的观察不同年龄右锁骨下静脉在X线下解剖学位置的变化,为临床提供参考。方法随机测量220例经右肘静脉穿刺中心静脉置管(peripherally inserted central catheter,PICC)的患者,按年龄不同分为:A组(<65岁);B组(≥65岁),每组110例。在仰卧位X线胸片下测量PICC管顶端纵向与横向在第一肋圈中的位置分布情况。结果 A组68例(62%)PICC管顶点通过第一肋圈中1/3;B组70例(64%)通过第一肋圈下1/3,两组间差异有统计学意义(P<0.01)。A、B组PICC管顶点距第一肋弓距离差异无统计学意义。结论 65岁以上高龄患者右锁骨下静脉的顶点位置较成年患者偏下,可为临床高龄患者锁骨下静脉穿刺提供参考。Objective To compare the anatomic difference of subclavian veins between old and young patients. Meth- ods Two hundred and twenty patients underwent right subclavian vein intubation were divided into two groups （110 pa- tients in each） ： A group （ 〈65 yr） and B group（ ≥65 yr）. The position of PICC tube were investigated and measured on chest films. Results 62% （68 cases） of PICC tube passed through the middle third of the first rib cycle, and 65% （70 cases） of PICC tube passed through the lower third of the first rib cycle. There was significant difference of PICC location between two groups. Conclusion The subclavian veins of old patients are lower than that of adult patients, which can be a valuable reference for subclavian vein intubation.

关 键 词：锁骨下静脉 静脉置管 X线解剖 肋骨 

分 类 号：R472[医药卫生—护理学]