不同的超声引导方式对颈内静脉血透导管置管术的影响  

Effects of different ultrasound-guided modes on catheter insertion of percutaneous internal jugular vein cannulation

作　　者：席春生[1] 刘冬梅[1] 关怀[1] 王谨涵[1] 李亚妹[1] 李芸[1] 高健[1] 张萌[1] 

机构地区：[1]兰州军区兰州总医院肾脏病内科,甘肃兰州730050

出　　处：《中国现代医学杂志》2015年第6期98-100,共3页China Journal of Modern Medicine

基　　金：兰州军区医药卫生科研基金资助项目(No:CLZ11JB01)

摘　　要：目的探讨不同的超声引导方式对经皮颈内静脉穿刺血透导管置管术成功率和并发症及操作时间的影响。方法总结分析了2011年5月-2013年4月兰州军区兰州总医院336例经临床评估需行血液净化治疗的肾脏病患者,在彩色多普勒超声实时引导下行经皮颈内静脉穿刺血透导管置管术,对比观察了横切、纵切以及横切定位纵切进针三种不同的超声引导方式对穿刺成功率和并发症及操作时间的影响。结果 336例患者中穿刺成功335例,成功率为99.7%,其中有1例因血管纤细颈内静脉穿刺置管失败,改行股静脉置管。本研究中所有病例均未发现严重并发症。颈动脉损伤发生率为0.9%。结论横切定位纵切进针的方式是血透导管置管术的最佳超声引导方式,成功率相似,并发症少,操作时间短,值得进一步观察和推广。【Objective】To investigate the effects of different ultrasound-guided modes on the success rate, complications and operating time of internal jugular vein cannulation catheter insertion.【Methods】Three hundred thirty-six patients with renal insufficiency requiring blood purification were performed internal jugular vein cannulation under ultrasound-guidance. The successful rate, complications and operating time were analyzed, and compared with the common ultrasound guidance modes. Three different ultrasound guidance modes were analyzed.【Results】Of all the patients, 335 cases were successively performed with internal jugular vein cannulation catheter insertion under three different ultrasound-guided modes. Only one patient failed to have internal jugular vein cannulation catheter insertion, then was performed with femoral vein cannulation catheter insertion. The total successful rate was 99.7%,the average time of cannulation catheter insertion was（18.5 ±4.5） min. The total rate of complication was 0.9%（3/336）. 【Conclusions】Ultrasound-guided deep vein cannulation catheter insertion is a kind of safe and accurate method for blood purification.

关 键 词：超声实时引导方式 经皮深静脉穿刺置管术 成功率 并发症 

分 类 号：R615[医药卫生—外科学]