150例昏迷病人围手术期颈外静脉穿刺的应用

Perioperatively Applying External Jugular Vein Puncture to 150 Neurosurgical Patients with Coma for Complementing Fluid

目的探讨颈外静脉穿刺置管用于神经外科昏迷病人围手术期输血补液治疗的方法和效果。方法采用套管针或中心静脉导管行颈外静脉穿刺并置管对昏迷及长期输液末梢血管不充盈的神经外科围手术期患者150例进行补液。其中有18例经颈外静脉置入中心静脉导管。结果150例颈外静脉穿刺患者,其中左侧59例,右侧81例,双侧10例;穿刺失败1例,患者自行拔除3例,脱落2例。结论颈外静脉穿刺置管补充液体用于昏迷病人安全可靠,穿刺成功率高,较中心静脉穿刺优势明显,在临床上值得广泛推广。

Objective To explore the technique and effect of complementing fluid through external jugular vein puncture in the neurosurgical patients with coma. Methods The clinical data of 150 patients with coma, who underwent neurosurgical operations and external jugular vein puncture for complementing fluid, was analyzed retrospectively. The other peripheral veins were not full and the long infusion of the fluid into the veins was necessary for the conditions of the 150 patients with coma. Results Of 150 patients undergoing external jugular vein puncture, 59 underwent the left external jugular vein puncture, 81 the right vein, and 10 the bilateral veins. The puncture failed in 1 fat patient. The catheters placed into the external jungular veins were unconsciously extracted by themselves in 3 patients with coma and slipped from the jungular veins in 2 patients. Conclusions Placing a catheter into the external jungular veins by puncture may meet with success at a high rate. The external jugular vein puncture is safer and better than the central vein puncture and should be extensively used clinically.