超声定位下颈内静脉穿刺置管的初步探讨

Preliminary study on the ultrasound localization of internal jugular vein catheterization

目的：探讨超声定位用于颈内静脉穿刺置管术的可行性,安全性,临床实用价值。方法：选择需行颈内静脉置管患者40例,男性29例,女性11例,年龄16-73岁,随机分为两组（n=20）,超声组和对照组。超声组首先用超声诊断仪确定穿刺静脉的位置,然后根据此结果进行颈内静脉穿刺置管。对照组采用传统解剖定位法进行穿刺置管。两种方法进行对照研究,观察比较穿刺置管一次成功率、并发症发生率。结果：对照组和超声组颈内静脉穿刺置管一次成功率分别为85%和100%,而且两组之间有非常显著性差异（P〈0.01） 并发症发生率分别为10%和0,两组并发症发生率之间有非常显著性差异（P〈0.01）。结论：超声定位有助于顺利完成深静脉穿刺置管,技术简单安全,患者经济负担小,值得推广应用。

Objective To discuss the feasibility, safety and clinical practical value of the ultrasound localization of internal jugular vein catheterization. Method Total 40 patients including 29 male and 11 female who needed to make the internal jugular vein catheterization, age 16 -73 years old, were randomly divided into the ultrasound group and the control group （n = 20）. The ultrasound group firstly were determined the location of vein puncture by ultrasonic diagnostic apparatus and then made the success of the internal jugular vein catheterization in accordance with the results of the location. The control group were conducted the catheterization using traditional anatomical location method. A success rate of catheterization and complication rate were respectively observed and compared in the matched ultrasound - control study. Results One time success rate of catheterization in the control group and the ultrasound group were 85% and 100% ,respectively, and between the two groups had very significant difference（ P 〈 0. 01 ）. Moreover,the complication rate of the ultrasound group was less than the control group, respectively 0 and 10% , and between the two groups had very significant difference （ P 〈 0. 01 ）. Conclusion The ultrasound localization contributes to the successful completion of deep vein catheterization, with simple and safe technology, little economic burden of patients ,therefore, it is worth popularizing.