二维超声仪对先天性心脏病患儿颈部血管定位的研究

Anatomic assessmetn of the jugular blood vessels in pediatric patients with congenital heart disease through echography.

用美国产便携式二维超声仪在５３例先天性心脏病患儿，对颈部两侧动静脉位置关系、直径和深度进行了观察。结果提示，去枕平卧头转向对侧并不能使颈内动静脉位置关系变得有利于穿刺，仅能使操作比较方便，颈部肌群张力对颈内动静脉位置关系有一定影响，颈部血管直径和深度与患儿身高和体重无明显相关，穿刺时进针深度不宜超过１．５～２ｃｍ。

To investigate common carotid artery (CCA) and internal jugular vein (IJV) in podiatric patients with congenital heart disease (CHD),fifty-three patients,aged 5 months to 5.5 years,scheduled to undergo cardiac surgery,were randomly selected to lie in the supine position without pillows. With the heads being upright or swung to the contralateral respectively,the adjacent relationship (AR),the depthes from the jugular skin and diameters of CCA and IJV in both sides were evaluated through a two dimensional echography. The AR between CCA and IJV was demonstrated by the subsequent parameters: A: CCA being lateral to IJV; B:CCA situated below IJV;C:CCA being medial to and partly below IJV;D:CCA being medial to IJV without superimposed image. The results showed that the depthes or diameters of CCA and IJV didn't correlated separately with heights or weights of the patients,and kept basically stable under thd different positions of head(p>0. 05). There wasn't a significant difference in diameter of CCA or IJV between both sides (P>0. 05 ). Following the upright head swung to the contralateral, in the right side A and B increased markedly (from 15.1% to 43.4% ),correspondingly,C and D decreased drastically(from 84. 9 % to 56.6 %) (P<0. 01),and in the left side the above parameters remained statistically unchaged (P>0. 05). It is concluded that the varation from the normal AR between CCA and IJV occurs in pediatric patient attacked with CHD,and with the head being swung to the contralateral,the AR between CCA and IJV is not conduetive to successful puncture,but only helpful in convenient operation.