超声引导锁骨下静脉穿刺置入中心静脉导管在肥胖患者中的应用

Application of color Doppler ultrasound-guided subclavian venous catheterization in fat sufferers

目的探讨超声引导锁骨下静脉穿刺置入中心静脉导管术(CVC)在肥胖患者中的应用价值。方法自2001年10月至2004年2月,对115例肥胖患者行锁骨下静脉穿刺置入中心静脉导管术。其中66例采用超声引导法,49例采用传统盲穿法。两种方法进行对照研究,观察结果包括置管一次成功率、并发症发生率。两组结果经显著性检验比较。结果采用超声引导法与传统盲穿方法对肥胖患者的锁骨下静脉穿刺置管一次成功率分别为100%(66/66)和91.8%(45/49,χ2=5.58,P<0.025),并发症发生率分别为0(0/66)和6.1%(3/49,χ2=4.14,P<0.05)。结论对于肥胖患者,超声引导法穿刺成功率明显优于传统盲穿法,并可避免并发症的发生,值得在临床推广应用。

Objective To approach the applying value of color Doppler ultrasound-guided subclavian venous catheterization in fat sufferers. Methods From Jan. 2001 to Feb. 2004, operations of subclavian venous catheterization were conducted on 115 fat sufferers, of which 66 patients were operated with the guidance of ultrasound, while the other 49 in traditional way. By contrasting with the two different methods, comparisons between the results were made, including the once-success rate of catheterization and the occurring rate of complication. Results The once-success rates with the guidance of color Doppler ultrasound and in traditional way were 100% （66/66） and 91.8%（45/49） respectively, χ^2 = 5.58, P 〈 0. 025. The occurring rates of complication were 0（0/66） and 6.1% （3/49） respectively, χ^2 = 4.14, P 〈 0.05. Compared with traditional subclavian venous catheterization, the once-success rate of puncture was higher than that of central venous catheterization, and no complication occured. Conclusions For fat sufferers, B-model ultrasound-guided subclavian venous catheterization is obviously better than traditional subclavian venous catheterization. As a new method, it is worth spreading in clinical practice.