超声引导与体表标志法行锁骨下/腋静脉置管的疗效对比  

Comparison of the effect of ultrasonic guidance and body surface marking in subclavian or axillary vein cannulation

作　　者：朱冬梅[1] 钟鸣[2] 吴威[2] 宋洁琼[2] 黄俊峰[2] 诸杜明[2] 何义舟[2] 

机构地区：[1]上海市松江区泗泾医院急诊科,上海201601 [2]复旦大学附属中山医院重症医学科,上海200032

出　　处：《中国临床医学》2016年第3期402-404,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:比较超声引导与体表标志两种方法行锁骨下/腋静脉置管的疗效。方法:回顾性分析行锁骨下/腋静脉置管的228例患者,包括超声引导组130例和体表标志定位组98例。所有患者置管后均拍摄胸片以确认有无气胸及导管异位的发生。结果:两组患者基线资料差异无统计学意义。超声引导组导管异位发生率低于体表标志定位组,但差异无统计学意义(0.9%vs 5.1%,P=0.09)。超声引导组未发现气胸,体表标志定位组气胸发生4例(4%),差异有统计学意义(P=0.03)。结论:超声引导下行锁骨下/腋静脉置管安全性高于体表标志法,但二者气胸和导管异位的发生率均较低,术后胸片检查应根据患者情况综合决定。Objective：To compare the efficacy of ultrasound guidance and body surface marking in subclavian or axillary vein cannulation.Methods：A retrospective analysis was performed on 228 patients with subclavian or axillary vein cannulation,including 130 cases in ultrasound-guided group and 98 cases in body surface marking group.Chest radiography was performed to confirm the occurrence of pneumothorax and catheter malposition in all patients.Results：There was no significant difference in baseline data between the two groups.The incidence of catheter malposition in ultrasound-guided group was lower than that in the body surface marking group,but the difference was not statistically significant（0.9% vs 5.1%,P=0.09）.No pneumothorax was found in the ultrasound-guided group,and 4cases of pneumothorax（4%）occurred in the body surface marking group,and the difference is statistically significant（P =0.03）.Conclusions： The safety of the subclavian/axillary vein catheter under ultrasound guidance was higher than that of the body surface marker,the incidence of pneumothorax and the incidence of the catheter malposition were both quite low,and postoperative chest X-ray examination should be decided according to the patient＇s symptoms.

关 键 词：气胸 胸片 锁骨下静脉 腋静脉 置管 

分 类 号：R735.9[医药卫生—肿瘤]