超声引导下颈内静脉穿刺术在强直性脊柱炎患者中的应用  

Applying the value of ultrasound guided internal jugular vein catheterization in patients with ankylosing spondylitis

作　　者：崔士和[1] 于漠涵 

机构地区：[1]南京大学医学院附属南京鼓楼医院麻醉科,210008 [2]新疆维吾尔自治区伊宁市人民医院麻醉科

出　　处：《国际麻醉学与复苏杂志》2015年第8期702-703,740,共3页International Journal of Anesthesiology and Resuscitation

摘　　要：目的评价超声引导下颈内静脉穿刺术在强直性脊柱炎（ankylosing spondylitis，AS）患者全身麻醉诱导后深静脉通路建立过程中的应用价值。方法选择20例拟择期行后路经椎弓根截骨矫形内固定术的AS患者，采用随机数字表法分为M组和C组，每组10例。全身麻醉诱导成功后，M组和C组分别采用体表标志定位法（盲穿法）和超声引导（可视化）行深静脉穿刺置管术，比较两种方法在一次性成功率、穿刺次数、穿刺时间、整体成功率、并发症发生率等方面的差异。结果M组一次性成功率低（20％），穿刺次数多（≥3处），失败率高（40％），误人动脉（30％）及局部血肿（20％）的并发症发生率高；C组一次性成功率高（70％），穿刺次数少（〈3处），100％成功，误入动脉（O）及局部血肿（10％）的并发症发生率极低；M组与C组比较，在穿刺次数、一次性成功率、整体成功率、误人动脉并发症4方面差异均存在统计学意义（P〈0．05）结论超声引导下颈内静脉穿刺术应用于AS患者，具有一次性成功率高、穿刺次数少、耗时短、100％成功的优势，明显减少相关并发症。Objective To evaluate the application of ultrasound guided internal jugular vein catheterization in the process of deep vein puncture in patients with ankylosing spondylitis（AS） after anesthesia induction. Methods Twenty AS patients scheduled for an elective pedicle subtraction osteotomy were enrolled in this study. The subjects were randomly assigned to receive the right internal jugular vein catheterization using either ultrasound-guided technique （group C, n=10） or traditional surface marker localization （group M, n=10）. One-time pun- cture success rate, number of punctures, duration of the procedure, total success rate and incidence of complication rate were compared between these two groups. Results The result of group M was extremely low, success rate at one-time puncture was（20% ）, several punctures（ I〉3 ）, high failure rate（40% ）, high rate of arterial damage related complication（30%） and local hematoma（20%）. Group C had higher success rate（70%） at one-time puncture, fewer repetitive punctures （〈3）, 100% success rate, lower complication rate due to artery damage（0%） and local hematoma（ 10% ）. Compared with group M, there were statistical differences at the four aspects of one -time success rate, number of repeated punctures, total success and complication of artery damage （P〈0.05）. Conclusions The application of ultrasound guided internal jugular vein catheterization in patients with AS has superior results, higher one-time success rate, fewer times of punctures, shorter time required for the procedure and 100% success rate.

关 键 词：超声引导 强直性脊柱炎 深静脉穿刺术 

分 类 号：R614[医药卫生—麻醉学]