全麻下超声联合DSA在儿童输液港植入术的临床应用  

Clinical application of ultrasound-guided neck internal jugular vein port implantation under general anesthesia combined with DSA

作　　者：王皎[1] 陆凤[1] 余婷 沈成齐 何国倩 孙静静[1] Wang Jiao;Lu Feng;Yu Ting;Shen Cheng-qi;He Guo-qian;Sun Jing-jing(Department of Pediatrics Hematologic Neoplasms Nursing,West China Second University Hospital,Sichuan University/West China School of Nursing,Sichuan University,Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,Chengdu 610041,China)

机构地区：[1]四川大学华西第二医院儿童血液肿瘤护理单元/四川大学华西护理学院,出生缺陷与相关妇儿疾病教育部重点实验室,四川成都610041

出　　处：《四川生理科学杂志》2023年第12期2262-2265,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨全麻下超声联合数字减影血管造影(Digital subtraction angiography,DSA)行颈内静脉儿童输液港植入术在临床应用的安全性及可行性。方法:回顾分析2022年4月至2023年2月,在我院行全麻下超声联合DSA行颈内静脉儿童输液港植入术的108例患儿临床资料。采用超声测量颈内静脉穿刺点静脉宽度,记录超声引导穿刺静脉时间、术中调管次数、术中并发症、术后并发症发生情况,计算植入成功率。结果:108例患儿均在全麻下超声联合DSA经颈内静脉成功植入输液港,无一例发生麻醉意外,超声引导下静脉穿刺成功率100%,术中未发生气胸、血胸、心率失常等致死性并发症,术中并发症发生率为零,术后早期并发症(术后30 d内)2例,发生率为1.85%,术后远期并发症(30 d后)4例,发生率为3.7%,未发生导管相关性血栓、导管异位/移位,夹闭综合症、药物外渗。结论:全麻下超声联合DSA行儿童输液港植入术安全、有效,能在保证穿刺成功率同时减少并发症发生,值得临床推广。Objective:To explore the safety and feasibility of ultrasound-guided neck internal jugular vein port implantation under general anesthesia combined with digital subtraction angiography(DSA)in pediatric patients for intravenous infusion.Methods:From April 2022 to February 2023,clinical data of 108 pediatric patients who underwent ultrasound-guided DSA neck internal jugular vein port implantation under general anesthesia in our hospital were retrospectively analyzed.Ultrasonic technology was used to measure the width of the internal jugular vein puncture point,the time taken of ultrasound guided vein puncture,the number of tube adjustments during operation,intraoperative complications,and postoperative complications were recorded,and the success rate of implantation was calculated.Results:All 108 pediatric patients successfully underwent the implantation of an infusion port through ultrasound-guided DSA under general anesthesia,with no incidents of anesthesia accidents.The success rate of vein puncture under ultrasound guidance was 100%.No fatal complications such as pneumothorax,hemothorax,or arrhythmia occurred during the procedure.There were no intraoperative complications,and early postoperative complications(within 30 days)occurred in 2 cases,with an incidence rate of 1.85%.Late postoperative complications(after 30 days)occurred in 4 cases,with an incidence rate of 3.7%.There were no occurrences of catheter-related thrombosis,catheter malposition/migration,pinch-off syndrome,or drug extravasation.Conclusion:The use of ultrasound combined with DSA for pediatric infusion port implantation under general anesthesia is safe and effective,which can ensure the success rate of puncture while reducing complications,and is worthy of clinical promotion.

关 键 词：麻醉 全身 超声检查 血管造影术 数字减影 完全植入式静脉输液港 

分 类 号：R614[医药卫生—麻醉学]