三角肌前缘定位锁骨下静脉穿刺置管在临床中的应用  

Anterior Margin of Deltoid Positioning Subclavian Vein Puncture Catheter in the Clinical Application

作　　者：甄茂盛[1] 范军[1] 薛典富 林贵文[1] 王长城[1] 李永刚[2] 

机构地区：[1]安徽省滁州市中西医结合医院麻醉科,239000 [2]安徽省滁州市中西医结合医院超声科,239000

出　　处：《医学理论与实践》2013年第15期1979-1981,共3页The Journal of Medical Theory and Practice

摘　　要：目的：探讨三角肌前缘定位行锁骨下静脉穿刺置管在临床上应用，改进传统锁骨下静脉穿刺定位方法，缩短穿刺时间，提高穿刺成功率。方法：128例ASA为2～5级的危重症患者分为两组：实验组（n=72）采用三角肌前缘定位行锁骨下静脉穿刺置管，对照组（n=56）采用传统锁骨下静脉穿刺置管，比较两种穿刺方法的穿刺定位标志明确性、首次穿刺成功率、首次穿刺成功用时、穿刺成功率、穿刺成功用时、置管困难率、穿刺失败率、穿刺并发症。结果：实验组定位标志明确性（93．1％）和首次穿刺成功率（90．3％）显著高于对照组（67．9％和71．4％，P〈0．01）；前者首次穿刺成功用时（6．8±3．2）min和穿刺成功用时（9．5±3．6）min显著短于对后者[（10．7±3．5）min和（12．8±4．1）min，P〈0．01）]。实验组穿刺置管成功率（97．2％）高于对照组（92．9％，P〈0．05）；置管困难、穿刺失败少于对照组（P〈0．05），实验组穿刺并发症3例次少于对照组5例次（P〈0．05）。结论：三角肌前缘定位法行锁骨下静脉穿刺置管，定位精确度高，首次穿刺成功率和总成功率高，穿刺用时短，并发症少。Objective： To investigate the feasibility of the anterior margin of deltoid the positioning line subclavian vein catheterization in clinical applications, to improve the traditional subclavian vein puncture, shorten the puncture time, improve the success rate. Methods： 128 patients with ASA 2-5 critically ill patients were divided into two groups, the experimental group （n=72） using the anterior margin of deltoid positioning subclavian vein puncture catheter control group （n= 56） using traditional subclavian vein catheterization, two puncture puncture mark clarity, the success rate for the first time,the times of the first puncture success, the success rate of puncture, the times of puncture success, rate of catheter difficulty, the puncture failure rate, puncture complications. Results： Positioning flag clarity 93. 1% and first- time success rate 90. 3% of the experimental group was significantly higher than the control group 67. 9% and 71.4% （ P〈0. 01 ） ; former first puncture success with （6. 8± 3. 2） min, and successful puncture （ 9. 5 ± 3. 6） min significantly shorter than the latter（10. 7±3.5）min and （12. 8±4. 1）rain （P〈0. 01）. Experimental group cannulation success rate （97.2%） higher than that of the control group （92. 9% ,P〈0. 05） ;catheter difficulties, puncture failure than the control group （P〈0. 05）, the experimental group puncture of hematoma 3 cases than the control group 5 cases （P〈0.05）. Conclusion.. anterior margin of deltoid location in subclavian vein catheterization tube, high positioning accuracy, the first puncture success rate and a high success rate,puncture with a short,fewer complications.

关 键 词：三角肌前缘 定位 锁骨下静脉穿刺置管 

分 类 号：R6[医药卫生—外科学]