两种穿刺入路方式中心静脉置管术在危重症抢救中的应用比较  

Comparison of Two Kinds of Application of Puncture Approach Ways of Central Vein Catheterization in Critically Ill Patients

作　　者：谢德东[1] 周莉娟[1] 陈力[1] 戴领[1] 

机构地区：[1]攀枝花市中心医院急救中心,四川攀枝花617067

出　　处：《四川医学》2014年第7期828-830,共3页Sichuan Medical Journal

摘　　要：目的比较两种穿刺入路方式中心静脉置管术在危重症抢救中的应用,寻求适用于危重症患者抢救中最优的中心静脉置管入路方式。方法回顾性分析2008年3月至2013年3月我中心900例危重抢救患者中心静脉置管术临床资料,其中采取颈内静脉穿刺入路方式420例,锁骨下静脉穿刺入路方式480例,通过对两种穿刺入路方式中心静脉置管术在快速穿刺成功率及穿刺相关并发症发生率方面进行分析比较。结果一针穿刺成功率:颈内静脉穿刺入路方式336例(80%);锁骨下静脉穿刺入路方式456例(95%);穿刺相关并发症发生率:颈内静脉穿刺入路方式69例(16.4%),锁骨下静脉穿刺入路方式20例(4.2%)。结论在危重症抢救中锁骨下静脉穿刺入路方式中心静脉置管术在快速穿刺成功率及穿刺相关并发症发生率方面优于颈内静脉穿刺入路方式。Objective To compare two kinds of puncture approach ways of central vein catheterization in the critically ill rescue application, in the way of central vein to seek for optimal rescue critically ill patients. Methods A retrospective analysis from 2008 March to 2013 year in March 900 cases of critically ill patients in our center of central venous catheterization patients clinical data, which take the internal jugular vein puncture approach in 420 cases, puncture of subclavian vein approach in 480 cases, based on the two kinds of puncture approach ways of central vein catheterization occurred in quick puncture success rate and puncture related complications rate analysis. Results The success rate of puncture of internal jugular vein puncture approach： 336 cases （80% ）; puncture of subclavian vein approach in 456 cases （95% ）; the incidence rate of puncture related complications： internal jugular vein puncture approach in 69 cases （16. 4% ）, puncture of subclavian vein in 20 cases （4. 2% ）. Conclusion In critically ill patients subclavian vein puncture approach ways of central vein catheterization rate is better than that of internal jugular vein puncture approach in fast puncture success rate and puncture related complications.

关 键 词：中心静脉置管术 危重症 抢救 

分 类 号：R472[医药卫生—护理学]