前斜角肌-锁骨间隙入路行锁骨下静脉穿刺置管的临床应用

Subclavian Vein Puncture and Catheterization Through Gap between Clavicle and Anterior Scalene Muscle

目的探讨前斜角肌-锁骨间隙入路行锁骨下静脉穿刺置管的可行性及其特点。方法选择需行中心静脉置管的患者120例,随机分为2组(n=60):实验组采用前斜角肌-锁骨间隙入路行锁骨下静脉穿刺置管,对照组采用颈内静脉穿刺置管。观察两组穿刺置管的总成功率、一次穿刺成功率、完成时间及并发症。结果试验组总成功率及一次穿刺成功率显著高于对照组(P<0.05或P<0.01),完成时间及并发症显著少于对照组(P<0.05)。结论前斜角肌-锁骨间隙入路行锁骨下静脉穿刺置管是一种高效、安全的中心静脉置管途径。

Objective To establish a method of subclavian vein puncture and catheterization through the gap between clavicle and anterior scalene muscle. Methods A total of 120 patients were recruited and randomly allocated into two groups （ n = 60/group）, and then were performed puncture and catheterization respectively in internal jugular vein and subclavian vein through the gap between the calvicle and anterior scalene muscle. Total success rate, flint time pricking success rate, complication incidence and puncture time were recorded. Results Higher first time pricking success rate and shorter puncture time with fewer adverse events were found in those who received supracalvicular subclavian vein puncture and catheterization. Conclusion Subclavian vein punc- ture and catheterization through the gap between calvicle and anterior scalene muscle is＇an effect and safe method to establishing central vein access.