心脏手术患儿超声引导右颈内静脉穿刺置管术的效果  

Efficacy of Ultrasound Guided Right Internal Jugular Vein Catheterization in Infants Undergoing Cardiac Surgery

作　　者：游仁芳[1] 李巧云[1] 谢平[1] 

机构地区：[1]中国人民解放军第180医院麻醉科,福建泉州362000

出　　处：《南昌大学学报（医学版）》2013年第12期56-58,共3页Journal of Nanchang University：Medical Sciences

摘　　要：目的 评价心脏手术患儿超声引导右颈内静脉穿刺置管术的效果.方法择期全身麻醉下行先天性心脏病手术患儿40例,月龄4-24月,体质量6-15 kg,采用随机数字表法,将患儿随机分为2组：超声引导组（U组,n=20）和体表解剖标志组（A组,n=20）.U组于麻醉诱导后在超声引导下行右颈内静脉穿刺置管术,A组采用传统体表标志定位法行右颈内静脉穿刺置管术.记录2组首次穿刺成功、首次置管成功、置管时间（穿刺开始到置入中心静脉导管的时间）、试穿次数和穿刺相关并发症发生情况.结果 U组首次穿刺成功率和首次置管成功率分别为100%和95%,明显高于A组的75%和70%（P〈0.05）;与A组比较,U组置管时间缩短、穿刺次数减少,穿刺相关并发症发生率降低（P〈0.05）.结论 超声引导可提高右颈内静脉穿刺置管成功率,缩短置管时间和减少并发症的发生,可安全有效地用于心脏手术患儿.Objective To evaluate the efficacy of ultrasound-guided right internal jugular vein catheterization in infants undergoing cardiac surgery. Methods Forty infants with congenital heart disease（age,4 to 24 months;body weight,6 to 15 kg） who were scheduled for elective sur- gery under the general anesthesia were randomly assigned to receive the right internal jugular vein catheterization using either ultrasound-guided technique（group U, n----20） or traditional surface marker localization（group A,n= 20）. The success rates of puncture and catheterization at the first attempt, catheterization time （from the start of puncture to the placement of central venous cathe ter）, number of puncture attempts and puncture-related complications were recorded in both groups. Results The success rates of puncture and catheterization at the first attempt in group U were significantly higher than those in group A（100% and 95 % vs 75 % and 70%, respectively; P〈0.05）. In addition, ultrasound-guided technique significantly decreased catheterization time, puncture number and puncture-related complications compared with traditional surface marker lo-calization（P〈0.05）. Conclusion Ultrasound guidance can increase the success rate of right in- ternal jugular vein catheterization, shorten catheterization time and reduce puncture-related com- plications. Therefore,ultrasound-guided right internal jugular vein catheterization is effective and safe in infants undergoing cardiac surgery.

关 键 词：超声引导 婴儿 颈内静脉穿刺置管术 心脏手术 

分 类 号：R654.2[医药卫生—外科学]