经胸锁乳突肌外侧缘颈内静脉穿刺置管的超声影像学研究  

Study of ultrasound imaging via lateral border of sternocleidomastoid by internal jugular vein catheterization

作　　者：李校宁[1] 韦晓勇 闵红星 陆波[3] 

机构地区：[1]石家庄市第一医院麻醉二科,河北石家庄050500 [2]宁夏医科大学,宁夏银川750004 [3]宁夏医科大学总医院,宁夏银川750004

出　　处：《生物医学工程与临床》2015年第5期494-497,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的 通过超声技术为经胸锁乳突肌（SCM）外侧缘行颈内静脉（IJV）穿刺置管提供影像学资料。方法 选择80例成年志愿者，其中男性43例，女性37例；年龄18 ～ 65岁，平均年龄41.8岁。采用B超分别在3个不同头位（头向左侧偏0°、30°、45°）、不同解剖水平面，观测每一例成年志愿者的右侧IJV与颈总动脉重叠率、IJV内径及其外侧缘至SCM外侧缘皮肤的距离。结果 右侧IJV与颈总动脉重叠率：头向左偏0°、30°、45°时，甲状软骨上缘水平面明显高于环状软骨、第7颈椎水平面（P 〈 0.01）；在环状软骨、第7颈椎水平面头向左偏0°、30°、45°时差异无统计学意义（P ＆gt; 0.05）。右侧IJV内径：头向左偏30°、45°时，环状软骨、第7颈椎水平面较甲状软骨上缘水平面均增宽（P 〈 0.05）；在甲状软骨上缘、环状软骨、第7颈椎水平面头向左偏0°、30°、45°时组内差异无统计学意义（P ＆gt; 0.05）。右侧IJV外侧缘至SCM外侧缘皮肤距离：头向左偏30°时，环状软骨、第7颈椎水平面较甲状软骨上缘水平面距离均缩短（P 〈 0.05）；头向左偏45°时，第7颈椎水平面较甲状软骨上缘水平面距离缩短（P 〈 0.05）；甲状软骨上缘水平面，头向左偏45°较0°距离缩短（P 〈 0.05）；环状软骨、第7颈椎水平面，头向左偏30°、45°较0°距离均缩短（P 〈 0.05）。结论 经SCM外侧缘行IJV穿刺置管相对理想的穿刺体位和区域为头向左偏30° ～ 45°、环状软骨到第7颈椎水平面区域。Objective To provide imaging data for lateral border of sternocleidomastoid（SCM） by internal jugular vein catheterization（IJV） via ultrasound imaging technique. Methods A total of 80 adult volunteers were enrolled, which included 43 males and 37 females, aged 18- 65 years old with mean age of 41.8 years old. At 3 different head positions and different anatomic levels, the overlap rate of right IJV, common carotid artery（CCA）, inner diameters of right IJV and distances from right IJV to skin of lateral border of SCM in adult volunteers by ultrasound imaging were analyzed and measured. Results The overlap rate of right IJV and CCA： when head turned 0°, 30°, 45° to left, level of superior border of thyroid cartilage was significantly higher than level of cricoid cartilage or the seventh cervical vertebra（P 0.01）; At level of cricoid cartilage or the seventh cervical vertebra, there was no statistical significance in head turned 0°, 30°, 45° to left（P 0.05）. The inner diameters of right IJV： when head turned 30°,45° to left, level of cricoid cartilage and the seventh cervical vertebra were wider than level of superior border of thyroid cartilage（P 0.05）; At level of superior border of thyroid cartilage, cricoid cartilage and the seventh cervical vertebra was no statistical significance when head turned 0°, 30°, 45° to left（P 0.05）. The distances from right IJV to skin of lateral border of SCM： when head turned 30° to left, level of cricoid cartilage and the seventh cervical vertebra was shorter than level of superior border of thyroid cartilage（P〉 0.05）; when head turned 45° to left, level of the seventh cervical vertebra was shorter than level of superior border of thyroid cartilage（P〈 0.05）; At level of superior border of thyroid cartilage, head turned 45° to left was shorter than 0°（P〈 0.05）; At level of cricoid cartilage and the seventh cervical vertebra, head turned 30°, 45° to left were shorter than 0°（P〈 0.05）.Conclusion It is demons

关 键 词：胸锁乳突肌 颈内静脉 穿刺置管 超声影像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R653[医药卫生—诊断学]