超声引导颈内静脉穿刺置管穿刺面的选择  

Optimal Axis View for Ultrasound-Guided Approach to Internal Jugular Vein Catheterization

作　　者：潘露菲[1] 苏靖诚[1] 李明惠[1] 谭宪湖[2] 

机构地区：[1]广西医科大学研究生学院,南宁市530021 [2]广西医科大学第一附属医院麻醉科,南宁市530021

出　　处：《广西医学》2014年第2期195-198,共4页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(Z2013020)

摘　　要：目的比较超声引导下行颈内静脉穿刺置管术短轴面、长轴面和长短轴面法的临床效果,探讨最佳穿刺面。方法择期手术需行超声引导下颈内静脉穿刺置管术的患者180例,按随机数字表法分为短轴面组、长轴面组和长短轴面组,每组60例,记录一般资料和穿刺情况。结果长轴面组和长短轴面组改变方向次数、成功刺入颈内静脉时间、总穿刺时间、技术难度评分明显少于短轴面组(P<0.05)。短轴面组、长轴面组、长短轴面组并发症发生率为18.33%(11/60)、6.67%(4/60),1.67%(1/60)。长短轴面组并发症发生率明显低于短轴面组(P<0.05)。结论长短轴面穿刺法兼具长轴面和短轴面穿刺法的优点,一次性穿刺成功率高,并发症少,安全快捷,是超声引导下行颈内静脉穿刺置管术的最佳穿刺面。Objective To observe the clinical effects of ultrasound-guided internal jugular vein catheterization with different axis views ,long axis view ,short axis view ,long-short axis view ,and to identify the optimal axis view for internal jugular vein catheterization .Methods One hundred and eighty patients requiring ultrasound-guided internal jugular vein catheterization were included in this study ,they were randomly divided into three groups ,long axis group , short axis group ,long-short axis group ,with 60 cases in each group .Their baseline characteristics and details of cathe-terization were recorded .Results Needle redirections , venous access time , total procedure time , technical difficulty reduced significantly in the long axis group and long-short axis group compared with short axis group （ P〈0 .05 ） .The complication rates of short axis group ,long axis group,long-short axis group were 18.33%（11/60）,6.67%（4/60）, 1.67%（1/60）,respectively.The complication rate in the long-short axis group was significantly lower than that in the short axis group （ P〈0 .05 ） .Conclusion The long-short-axis ultrasound-guided technique has the benefits of long-axis and short-axis ultrasound-guided techniques ,with high first-pass success rate and less complication rate ,which is a safe,fast,and the best technique for ultrasound-guided internal jugular vein catheterization .

关 键 词：颈内静脉穿刺置管 超声引导 短轴面 长轴面 长短轴面 

分 类 号：R445.1[医药卫生—影像医学与核医学]