经锁骨上途径行锁骨下静脉穿刺置管应用于婴儿及新生儿的研究  

Clinical study of percutaneous subclavian venous puncture and catheterization through the supracla ricular approach in infants and neonates

作　　者：谭冠先[1] 赵丽妮[1] 谭宪湖[1] 林成新[1] 彭劲松[1] 秦科[1] 

机构地区：[1]广西医科大学第一附属医院,南宁530021

出　　处：《医学文选》2004年第1期2-4,共3页Anthology of Medicine

基　　金：广西壮族自治区卫生厅立项项目 (合同号 :桂卫 Z2 0 0 0 2 9)

摘　　要：目的　探讨经锁骨上途径行锁骨下静脉穿刺置管用于婴幼儿和新生儿的可行性。方法　随机选择拟施行大手术的婴儿和新生儿 43例 ,其中 1岁以下婴儿 3 9例、新生儿 4例。全麻后经锁骨上途径行锁骨下静脉穿刺置管。观察记录穿刺置管总成功率 ,一次穿刺成功率 ,平均穿刺成功时间 ,平均穿刺置管完成时间 ,进针深度。结果　穿刺置管成功41例 (95 .3 % )。一次穿刺成功 2 3例 (5 3 .5 % ) ,平均穿刺成功时间 (3 1 .46± 1 1 .42 ) s,平均穿刺及置管完成时间 (1 86.46± 5 2 .68) s,平均进针深度 (1 .42± 0 .3 1 ) cm。无并发症发生。结论　经皮锁骨上途径行锁骨下静脉穿刺置管用于婴儿和新生儿总成功率及一次穿刺成功率较高 ,无并发症发生 。Objective To evaluate the effect of supraclavicutar subclavian puncture and catheterization in infants and neonates.Methods 39 infants(age≤1 years) and 4 neonates(age ≤1 Months) were undergone major surgery.After general anesthesi,the subclavian vein puncture and catherization through the supraclavicalar approach were performed.The total success rate of puncture and catheterization,the success rate of puncture at the first attempt,the median time from start of puncture to aspiration of blood,the median time from start of puncture to end of cannulation were recorded and the deepness of insert the needle were measured.Results The total puncture and cannulation were success in 41 cases(95 3%),and 53 5% of the patients the vein was puncture at the first attempt.The median time from start of puncture to aspiration of blood and from start of puncture to end of cannulation were 31 46±11 42s and 186 46±52 68s.There were no complications such as accidental arterial puncture,pneumothorax and hematothorax.Conclusions The results indicate that supraclavicular subclavian venous catheterization is a reliable and safe technique for infants and neonates.

关 键 词：插管法 锁骨下静脉穿刺置管术 婴儿 新生儿 

分 类 号：R472[医药卫生—护理学]