一种快速定位腋静脉的新方法  

A new method for rapid location of axillary vein

作　　者：张烨 黄小宁[2] 彭碧波[2] 张功伟 李金[3] 王义兵[3] 王伟[3] Zhang Ye;Huang Xiao-ning;Peng Bi-bo;Zhang Gong-wei;Li Jin;Wang Yi-bing;Wang Wei(Department of Critical Care Mediciney East Hospital,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院东院重症医学科,湖北武汉430060 [2]南昌大学第二附属医院影像科,江西南昌330006 [3]南昌大学第二附属医院急诊科,江西南昌330006

出　　处：《中国急救医学》2021年第8期704-708,共5页Chinese Journal of Critical Care Medicine

基　　金：江西省卫生计生委普通科技计划(20165189);江西省科技厅重点研发计划项目(20181BBG78032)。

摘　　要：目的旨在寻找一种定位腋静脉的新方法。方法回顾性分析327例颈部至颅底CT血管造影(computed tomography angiography,CTA)检查患者的影像资料,研究腋静脉与同侧锁骨之间的解剖位置关系,在垂直线上,计算锁骨中点到腋静脉近端点的距离,同时计算锁骨肩峰端垂直线和锁骨胸骨端水平线交点到腋静脉远端点的距离,通过实时床旁超声再次精确定位腋静脉远端点和近端点的位置,明确腋静脉走向,为腋静脉定位方式。通过相关性统计分析和直线回归方程分析患者锁骨长度和身高与这两个垂直距离的相关性,进一步揭示其使用价值。结果这两个垂直距离以性别分组的独立样本的t检验,差异无统计学意义(P> 0.05),锁骨中点至腋静脉近端的垂直距离为(19.51±2.80) mm,锁骨肩峰端垂直线和锁骨胸骨端水平线交点至腋静脉远端的垂直距离为(31.82±4.58) mm;锁骨长度、身高与这两个垂直距离均符合正态分布特征;这两个垂直距离分别与锁骨长度、身高存在正相关性,并且这两个垂直距离之间也存在正相关性;根据标准误差大小,以实际身高、锁骨长度为自变量分别通过回归方程y=-6.108+0.002x、y=23.930+0.060x推算出这两个垂直距离。结论以锁骨为骨性标志定位腋静脉给临床提供了一种新方法。Objective To find a new method to locate axillary vein. Methods To retrospectively analyze imaging data of 327 cases with neck to skull base of computed tomography angiography( CTA) check,and to research the relationship of the anatomical position between axillary vein and ipsilateral collarbone. On the vertical line,the distance from the midpoint of clavicle to the proximal end of axillary vein was calculated. The distance from the intersection of vertical line of clavicular acromial end and horizontal line of clavicular sternal end to the distal end of axillary vein was also calculated. To accurately locate the position of the distal and proximal end of axillary vein again by real-time bedside ultrasound,and to determine the direction of axillary vein,so as to provide a location method for axillary vein puncture. The correlation between the length and height of clavicle and the two vertical distances was analyzed by correlation statistical analysis and linear regression equation,and its adaptive value was further revealed. Results There was no significant difference between the two independent samples of vertical distance grouped by sex( P > 0. 05). The vertical distance from the midpoint of clavicle to the proximal end of axillary vein was( 19. 51 ± 2. 80) mm,and the vertical distance from the intersection of the vertical line of clavicular acromial end and the horizontal line of clavicular sternal end to the distal end of axillary vein was( 31. 82 ± 4. 58) mm;The length and height of clavicle and the two vertical distances all accorded with normal distribution characteristics;The two vertical distances were positively correlated with the length and height of clavicle,and there was a positive correlation between the two vertical distances. According to the standard error,the two vertical distances were calculated by regression equation y =-6. 108 + 0. 002 x and y = 23. 930 + 0. 060 x respectively with actual height and collarbone length as independent variables. Conclusions Clavicle as a bone marker provides

关 键 词：CT血管造影(CTA) 定位 腋静脉 新方法 

分 类 号：R-3[医药卫生]