彩色多普勒超声定位与体表解剖定位行中心静脉置管术在血液透析患者中的临床比较  

Clinical comparison of color Doppler ultrasound localization and anatomic landmarks localization for hemodialysis in central veins catheterization

作　　者：刘蔓莉[1,2] 皮婧静[1,2] 杨斌[1,2] 崔路可[1,2] 龚蓉[1,2] 程弓[1,2] 

机构地区：[1]重庆医科大学附属第二临床学院 [2]成都市第三人民医院肾脏科,四川成都610031

出　　处：《四川医学》2013年第6期795-797,共3页Sichuan Medical Journal

摘　　要：目的比较彩色多普勒超声定位及体表解剖定位行中心静脉置管术在血液透析患者中的临床操作及并发症情况。方法筛选终末期肾功能不全(ESRD)需要进行中心静脉置管的患者共120例,分别进行彩色多普勒超声定位及体表解剖定位行颈内静脉、股静脉穿刺置管,每组30例,比较1次穿刺置管成功例数、平均操作时间、并发症发生情况。结果彩色多普勒超声定位颈内静脉组及股静脉组平均操作时间明显少于体表解剖定位颈内静脉组及股静脉组,差异有统计学意义(P<0.05);彩色多普勒超声定位较体表解剖定位1次穿刺置管成功率、动脉穿刺损伤、血肿等并发症发生率相比差异没有统计学意义(P>0.05)。结论彩色多普勒超声定位较体表解剖定位行中心静脉置管术操作时间短,更为安全,推荐采用;体表解剖定位中心静脉置管术技术熟练,对并发症正确处理,仍可以开展。Objective To compare the clinical operation and complications between color Doppler ultrasound localization and anatomic landmarks localization used for hemodialysis in central veins catheterization.Methods 120 ESRD patients who needed central veins catheterization were enrolled and were equally divided into four groups.Jugular vein catheters or femoral vein catheters were putted in by either ultrasound localization or anatomic landmarks localization.The number of one-time success,the average time of catheterization,the number of complications were compared between four groups.Results The average time of catheterization in ultrasound-guided jugular vein group and femoral vein group was significantly less than which in anatomic landmarks-guided jugular vein group and femoral vein group（P0.05）.There is no difference between ultrasound-guided groups and body surface landmark-guided groups in one-time success rate,arterial injury rate and hematoma rate（P0.05）.Conclusion The color Doppler ultrasound-guided central veins catheterization is more efficient and safer than anatomic landmarks-guided central veins catheterization.Therefore this technique was recommended in clinical practice.If the technique of anatomic landmarks-guided central veins catheterization was proficient and the complications can be dealt with correctly,this technique still can be used.

关 键 词：血液透析 中心静脉置管术 并发症 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692.5[医药卫生—诊断学]