改良锁骨下静脉置管术在神经外科重症监护室的应用  

Application of modified subclavian vein catheterization via subclavian approach in Neurosurgery Intensive

作　　者：郭建[1] 展如才[1] 张彬彬 李盛杰 孙金龙[1] 

机构地区：[1]山东大学附属山东省千佛山医院神经外科,山东省济南250014 [2]乳山市人民医院神经外科,山东省乳山265400

出　　处：《中国基层医药》2017年第23期3628-3632,I0002,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 观察改良锁骨下静脉置管术（SVC）在神经外科重症监护室应用的效果及并发症发生情况,意在改进锁骨下静脉置管术的应用.方法 回顾性分析接受锁骨下静脉置管术的292例神经外科重症监护室患者的临床资料,按照SVC方法不同分组,其中65例患者接受常规穿刺方法,227例采用改良方法,比较两种锁骨下静脉置管术的成功率及并发症发生率.结果 采用常规方法成功率为93.8％,发生各种与穿刺、置管有关的并发症发生率为29.5％.采用改良方法穿刺成功率为99.1％,并发症发生率为7.1％.改良组在穿刺成功率、并发症方面明显优于传统方法（x^2 =4.61、7.32,均P＜0.05）.结论 采用改良锁骨下静脉置管术提高了成功率、降低了并发症发生率.操作要领易于掌握,使用便捷,适合在神经外科重症监护室采用.Objective To evaluate the safety and efficacy of the modified subclavian vein cathetrization （SVC） in Neurosurgical Intensive Care Unit （NICU）.Methods The clinical data of 292 patients experienced SVC in NICU over a 3-year-and-9-month periodwere retrospectively analyzed,and they were divided into groups by the method of SVC,in which 227 patients underwent modified SVC were identified and compared with 65 patients who underwent routine SVC during the same period.Medical charts of the patients were reviewed to collect demographic information,such as age,sex,rate of success at first-puncture and complications.Statistical comparisons between the two groups were made using Chi-square analysis for the variables and were considered to be statistically significant if P 〈 0.05.Data were analyzed using SPSS 19.0 （Armonk,NY：IBM Corp,USA）.Results In the SVC group,the total success was achieved in 61 patients （93.8%）,and the incidence rate of complications related to puncture and cathetrization was 29.5%.In the mSVC group,the total successful rate was 99.1%,and the incidence rate of complications related to puncture and cathetrization was 7.1%.The mSVC was better than traditional SVC in successful rate and incidence rate of complications related to puncture and cathetrization （x^2 =4.61,7.32,all P 〈 0.05）.Conclusion mSVC for the patients in NICU is a safe and effective technique with low morbidity and mortality.

关 键 词：导管 留置 锁骨下静脉 神经外科手术 重症监护病房 

分 类 号：R472[医药卫生—护理学]