提高锁骨下静脉穿刺成功率的方法

目的提高锁骨下静脉穿刺置管的成功率。方法穿刺点为锁骨中点下缘下方约1 cm,再偏外侧1 cm 处,即锁骨下缘中1/3交界处,穿刺方向指向胸锁乳突肌胸骨头与锁骨形成的夹角平分线上1cm处,穿刺针头进入锁骨下后把肩膀、针栓同时往下压,使针尖向上,且进针行针紧贴锁骨进行。结果 83例患者中一次性穿刺成功78例,占 93．98％,误入动脉3例,占3．61％,穿刺失败2例,占2．41％,未发生气胸并发症。结论改进后的锁骨下静脉穿刺方法,提高了穿刺的成功率,减少了并发症的发生,效果良好。

Objective In order to increase the success rate of intubation in subclavian vein. Methods Puncture point is 1 cm away from the inferior border of clavicle midpoint and 1 cm from the lateral side. That is located at the juncture of the clavicle inferior border midpoint and the 1/3 lateral side. The puncture directed towards the point which is 1 cm away on the bisection line of the included angle formed by the thoracic bones and clavicle. The shoulders and syringe piston were simultaneously pressed downwards after the puncture needle tip entered the clavicle. Results 78 patients were successfully punctured among the total 83 patients, accounting for 94% and no pneumothorax complication. Conclusion The improved puncture method of subclavian vein increased the success rate of puncture, decrease the occurrence of complication.