改良式颈内静脉置管法的临床应用研究，

Clinical study on modified catheterization of internal jugular vein

目的对颈内静脉置管方法改良，为外周血管条件差而又需要长时间接受治疗或化疗的患者，选择一条良好的静脉通道。方法采用回顾性研究法，选择我院2008年1月至2009年11月间行改良式颈内静脉置管术患者30例为改良式颈内静脉组；同期行常规颈内静脉置管术（CVC）患者87例为常规颈内静脉组，经外周静脉穿刺中心静脉置管术（PICC）患者158例为上肢静脉组，根据我院自行设计使用的住院患者管道护理交接班记录表，分别统计三组置管成功率、导管留置时间及置管并发症情况，并分析其利弊。结果三组置管成功率比较差异无统计学意义（P〉0．05），但上肢静脉组一次置管成功率94．3％，高于其他两组；改良式颈内静脉组主要并发症发生率为3．3％，明显低于其他两组（P〈0．05）；改良式颈内静脉组的导管留置时间也明显长于其他两组（P〈0．05）。结论改良式经颈内静脉置管法，不限制患者的臂部活动，并发症少，留置时间长，是一条理想的深静脉通道，值得临床推广应用。

Objective To make a better route for the patients needing routine or chemical treatment for long time with bad condition of peripheral veins by modifying the method of cathetering the internal jugular vein. Methods Thirty patients received modified method between 2008.01 and 2009.11. were selected as MJ group in this retrospective research. 87 patients were included for the usual cathetering into the internal jugular vein and selected as, Group J and 158 patients were as Group P for cathetering through the peripheral vein. According to the situation of catheters, indices, such as success ratio, staying duration and complication, were statistically coped with to analyze its advantage and disadvantage. Results There was no statistical difference of success ratio among three groups （ P 〉 0. 05 ）, but the success ratio from Group P was up to 94.3% and was higher than those of the other two groups. The incidence of complication from Group MJ was 3.3%, lower than the other two groups （ P 〈 0. 05 ）. The staying duration of Group MJ was obviously longer than the others. Conclusions The method of modified cathetering the internal jugular vein with PICC catheter did not limit the body. Its complications were shown less and its staying duration lasted longer. This method is a better route via deep vein and is worth spreading.