超声定位与解剖标志法行颈内静脉穿刺置管的比较研究

The comparision between the ultrasound localization with the anatomical landmark method for central venous catheterization through the right internal jugular vein

目的 将超声定位技术与解剖标志法行颈内静脉穿刺置管进行对比研究,旨在阐明超声引导定位穿刺是一种非常有价值而且很有必要开展的创新技术与手段.方法 择期消化道肿瘤切除病人100例,A5A Ⅱ-Ⅲ级,随机分为超声组(B组)和解剖标志组(T组),每组均为50例,麻醉诱导气管插管后需行颈内静脉穿刺置管.超声组在B超定位后穿刺,解剖标志组采用体表标志定位穿刺,分别记录首次穿刺成功率,穿刺次数及操作时间.结果 超声组首次穿刺的成功率,穿刺的次数,操作的时间均明显优于传统组(P＜0.05).结论 采用超声引导行颈内静脉穿刺定位准确,成功率高,操作省时简便而且安全,是一种有必要开展的创新技术与手段.

Objective To compare the ultrasound-guided technique with the anatomical landmark method for central venous catheterization through the right internal jugular vein.Methods 100 patients undergoing gastrointestinal operations were randomized into ultrasound group(group B) and the anatomical landmarks group(group T),50 patients in each group.In group B,cannulation was performed by using ultrasound scanner.The patients' internal jugular veins were cannulated by using the anatomical method to palpate the carotid pulsation and identify the other anatomical landmarks.The first attempt success rate,number of attempts and cannulation time were recorded to compare between the two groups.Results Compared with group T,the first attempt success rate of venous cannulation was higher,the number of attempts was less,and the cannulation time was shorter in group B(P<0.05).Conclusion Ultrasound localization of the right internal jugular vein could significantly increase cannulation success rate,shorten the number of attempts and cannulation time.The technique was helpful and convenient for clinic service.