肥胖患者血管横切平面内法颈内静脉穿刺置管的可行性  

Feasibility of internal jugular vein catheterization guided by blood vessels crosscut ultrasound in obese patients

作　　者：彭深渠[1] 古昌剑 曹振刚[1] 张淑芳[1] 张翔[1] 张新峰[1] 

机构地区：[1]新疆生产建设兵团第一师医院麻醉科,新疆阿克苏843000

出　　处：《新疆医学》2018年第1期71-73,共3页Xinjiang Medical Journal

基　　金：2016年新疆生产建设兵团第一师市科研与推广计划项目(2016YL03)

摘　　要：目的探讨肥胖患者血管横切平面内超声引导技术在颈内静脉穿刺置管的可行性。方法因病情需要或因肥胖而外周静脉通道建立困难且需要行颈内静脉穿刺置管的肥胖患者40例,年龄、性别不限,体重指数>28 kg/m2。依据随机数字表随机的分为两组,每组患者各20例,超声引导组(U组)和传统方法组(C组),两组患者均选择右侧颈内静脉中段入路穿刺,U组在超声引导可视化下进行穿刺;传统组采用体表解剖标志定位,由熟练颈内静脉穿刺术的成员进行穿刺。记录穿刺置管时间、首次置管成功人数、穿刺短期并发症。结果2组患者一般情况无差异(P>0.05),U组一次性穿刺成功率高于C组(P=0.044),U组穿刺总时长较C组短(P=0.024),有显著性统计学意义。U组在穿刺中有1例患者出现动脉血肿,C组有3例患者出现动脉血肿,组间差异无统计学意义(P>0.05),2组患者均未观察到穿刺失败、气胸、血气胸等并发症。结论血管横切平面内超声引导技术可准确的定位穿刺肥胖患者的颈内静脉,副损伤小、穿刺时间短、一次性成功率高,值得推广。Objective To explore the feasibility of intravascular ultrasound guided technique for internal jugular vein catheterization in obese patients. Methods Forty obese patients, whose body mass index were above 28 kg/m2, were randomly divided into two groups,ultrasound group（U group） and traditional group（C group）. Patients were punctured in the middle of right internal jugular vein. U group were punctured under ultrasound, and traditional group were guided by body section mark. The time of puncture and catheterization,successful catheterization or not, and the short-term complications of puncture were recorded. Results There was no difference between the general situation of two groups of patients（P〈0.05）. Success rate of first-time puncture in group U was higher than that of C group（P=0.044）. Puncture time in group U was shorter than that of group C（P=0.024）. In group U, artery hematoma occured in one patient. In group C, artery hematoma occured in three patients, with no significantly statistical differences between two groups（P〈0.05）. Conclusion Ultrasound guidance can accurately locate the internal jugular vein among obese patients, with less injury, shorter puncture time and higher first-time success rate, and it is worthy of promotion.

关 键 词：超声 肥胖 中心静脉 穿刺置管 

分 类 号：R589.3[医药卫生—内分泌]