超声定位在肥胖患者经颈内静脉穿刺置入中心静脉导管中的应用  

Application of Ultrasonic Surface Location for Internal Jugular Vein Catheterization in the Obesity

作　　者：赵丽艳[1] 常庚申[1] 康定坤[1] 

机构地区：[1]河南省洛阳正骨医院,河南洛阳471002

出　　处：《中国医学创新》2014年第23期55-57,共3页Medical Innovation of China

摘　　要：目的:探讨超声定位在肥胖患者经颈内静脉穿刺置入中心静脉导管中临床应用的可行性。方法:拟行颈内静脉穿刺置入中心静脉导管的肥胖患者共80例,随机分为超声定位组40例和解剖定位组40例,超声定位组在terason 2000+彩色超声引导系统定位后进行颈内静脉穿刺置入中心静脉导管,解剖定位组按照体表解剖标志定位后进行颈内静脉穿刺置入中心静脉导管,观察比较两组一针穿刺成功率、穿刺置管时间、发生误穿动脉、局部血肿、损伤神经、气胸等并发症的发生率。结果:超声定位组一针穿刺成功率为98%,明显高于解剖定位组的73%(P<0.05),超声定位组穿刺置管时间为(9.7±2.6)min,明显短于解剖定位组的(15.4±3.1)min(P<0.05);超声定位组无一例发生并发症,发生率明显低于解剖定位组的15%(P<0.05)。结论:超声定位应用于肥胖患者经颈内静脉穿刺置入中心静脉导管可缩短穿刺置管时间,穿刺成功率高,并发症发生率低,更适合在临床上应用。Objective：To explore the utility of ultrasonic surface localization for internal jugular vein catheterization in the obesity. Method：Totally 80 obesity patients received internal vein catheterization were randomized into ultrasonic surface positioning group（40 cases）and anatomical landmark group（40 cases）. The terason 2000＋color ultrasonic-guided system was used to locate the puncture point in ultrasonic group,and surface marks were used in anatomic landmark group.The success rate of the first puncture attempt,the time of puncturing and catheterization,and the complications were observed and recorded.Result：The success rate of the first puncture attempt of ultrasonic group was 98%,it was greater than 73%of anatomic group（P〈0.05）.Ultrasonic group required less time（9.7±2.6）min versus anatomic group（15.4±3.1）min（P〈0.05）.The incidence of complications was fewer for ultrasonic group（0） versus anatomic group（15%）（P〈0.05）.Conclusion：Ultrasonic surface positioning applied for internal jugular vein catheterization in the obesity requires less time,increases the success rate of the first puncture attempt,and decreases the incidence of complications,so it is suitable for clinical application.

关 键 词：超声 肥胖 颈内静脉 中心静脉导管 

分 类 号：R589.2[医药卫生—内分泌]