经颈内静脉进行中心静脉置管的解剖研究及临床意义  

Anatomical study and clinical significance of central venous catheterization via the internal jugular vein

作　　者：陈永正 刘维 周旭茹 黎珂仰 张功铭 梁伟旭 张钰瑞 张子晴 陈飞 陈志国[3] Chen Yongzheng;Liu Wei;Zhou Xuru;Li Keyang;Zhang Gongming;Liang Weixu;Zhang Yurui;Zhang Ziqing;Chen Fei;Chen Zhiguo(Department of Imaging,Pingdingshan Hospital of Traditional Chinese Medicine,Pingdingshan 467000,Henan Province,China;School of Basic Medicine,Xinxiang Medical University,Xinxiang 453000,Henan Province,China;Laboratory of Gross Morphology,School of Basic Medicine,Xinxiang Medical University,Xinxiang 453000,Henan Province,China)

机构地区：[1]平顶山市中医医院影像科,河南平顶山467000 [2]新乡医学院基础医学院,河南新乡453000 [3]新乡医学院基础医学院大体形态学实验室,河南新乡453000

出　　处：《中国临床解剖学杂志》2024年第4期419-423,共5页Chinese Journal of Clinical Anatomy

摘　　要：目的测量颈内静脉穿刺置管长度及途经血管半径,为临床经颈内静脉进行中心静脉穿刺置管提供形态学依据。方法选取31具防腐成年大体标本,解剖静脉全程及其属支,确定穿刺入针点和置管终点,测量置管通路左、右侧入路点到各属支及终点的长度和血管压扁径,依据压扁径推算半径。结果左侧入路,至锁骨下静脉长度(20.47±9.08)mm;左右头臂静脉交汇处(91.17±14.12)mm;终点(148.27±17.25)mm。右侧入路,至锁骨下静脉长度(21.59±7.32)mm;左右头臂静脉交汇处(61.06±9.74)mm;终点(123.22±12.68)mm。左侧,颈内静脉半径(3.85±1.29)mm;锁骨下静脉(4.64±1.07)mm;头臂静脉(5.08±1.01)mm。右侧,锁骨下静脉半径(4.79±0.89)mm;颈内静脉(5.03±1.65)mm;头臂静脉(5.23±0.91)mm。上腔静脉半径(7.92±0.97)mm;奇静脉(4.16±1.21)mm。结论右侧入路行颈内静脉穿刺置管术优势大于左侧;左侧用长度20cm导管、右侧用长度15cm导管可基本满足临床需求。Objective To measure the length of internal jugular vein puncture and catheterization and its transvascular radius,so as to provide morphological basis for central venous puncture and catheterization through the internal jugular vein in clinical practice.Methods Thirty-one adult gross cadavers were selected,and the entire course of the veins and their tributaries were dissected to determine the puncture entry point and the end point of the catheterization.The length from the left and right approach points to each tributary and to the end point,as well as the flattening diameter of the vessels were measured.The radius was calculated based on the flattening diameter.Results For the left approach,the average length to the subclavian vein was(20.47±9.08)mm;to the junction of the left and right brachiocephalic veins(91.17±14.12)mm;and to the end point(148.27±17.25)mm.For the right approach,the average length to the subclavian vein was(21.59±7.32)mm;to the junction of the left and right brachiocephalic veins(61.06±9.74)mm;and to the end point(123.22±12.68)mm.On the left side,the average radius of the internal jugular vein was(3.85±1.29)mm;subclavian vein(4.64±1.07)mm;and brachiocephalic vein(5.08±1.01)mm.On the right side,the average radius of the subclavian vein was(4.79±0.89)mm;internal jugular vein(5.03±1.65)mm;and brachiocephalic vein(5.23±0.91)mm.The average radius of the superior vena cava was(7.92±0.97)mm;and the azygos vein(4.16±1.21)mm.Conclusions The right approach for internal jugular vein puncture and catheterization has greater advantages than the left side;a 20 cm catheter on the left side and a 15 cm catheter on the right side can basically meet clinical needs.

关 键 词：中心静脉置管 颈内静脉 解剖 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学]