经锁骨上途径行锁骨下静脉穿刺置管在ICU中的应用

Application of subclavian vein puncture and catheterization via percutaneous supraclavicular approach in ICU

目的:探讨经锁骨上途径行锁骨下静脉穿刺置管用于ICU的可行性。方法:选择ICU中需行深静脉穿刺置管的患者346例,经锁骨上途径组183例和经锁骨下途径组163例,在局麻下完成锁骨下静脉穿刺置管。结果:经锁骨上途径组比锁骨下途径穿刺组操作时间短(P<0.05),进针深度较浅(P<0.05),一次穿刺成功率较高(P<0.05),并发症较少(P<0.05),两组总穿刺成功率比较差异无统计学意义(P>0.05)。结论:锁骨上途径用于ICU中的锁骨下静脉穿刺置管快速,安全,并发症少,值得推广。

Objective. To evaluate the effectiveness of subclavian vein puncture and catheterization via percutaneous supraclavicular approach in ICU. Methods： A total of 346 patients to be treated by deep venous puncture and catheterization were divided into two groups ： patients in the first group （n = 183） treated via supra- clavicular approach and those in the second group （n = 163 ） via subclavian approach. The surgical management was performed under the condition of local anesthesia. Results： Compared with the supraclavicular approach group, shorter operative time, shorter puncture length, higher success rate of first puncture, but less complications were found in the supraclavieular approach group （P 〈0.05 in all）, There was no significant difference in the total success rate between the two groups （P 〉 0.05）. Conclusion： Subclavian vein puncture and catheterization via percutaneous supraclavicular approach for ICU patients prove to be rapid and safe with fewer complications and may have wider application in clinical practice