超声多普勒技术在323例危重症患者颈内静脉穿刺置管术中的应用

Application of Doppler Ultrasound in Internal Jugular Vein Catheterization: Analysis of 323 Critically Ill Patients

目的:探讨超声多普勒技术在危重症患者颈内静脉穿刺置管中的临床应用价值。方法:选取323例预计颈内静脉穿刺困难的危重症患者,在超声引导下行右颈内静脉穿刺置管,记录穿刺时间、一次穿刺置管成功率、二次以上穿刺置管成功率及并发症发生例数。结果:323例患者均在超声引导下行右颈内静脉穿刺置管成功,无一例因穿刺失败改行其他部位中心静脉穿刺。超声多普勒引导穿刺置管操作时间184.6±20.5s。超声多普勒引导一次穿刺置管成功率93%。超声多普勒引导二次以上穿刺置管成功率100%。并发症发生率4.64%。结论:应用超声多普勒技术引导危重症患者颈内静脉穿刺置管,缩短了置管时间,减少了穿刺次数,提高了一次穿刺成功率。

Objective： To investigate the application of doppler ultrasound in critically ill patients with internal jugular vein catheterization. Methods： 323 cases of anticipated difficult internal jugular vein in critically ill patients, the ultrasound guided right internal jugular vein puncture, puncture record time, a success rate of catheterization, more than twice the success rate of catheterization and complications place the number of cases. Results： 323 patients were in the ultrasound guided right internal jugular vein catheterization successfully, no case be diverted to other parts due to puncture failure of central venous puncture. Doppler ultrasound guided catheter placement operation time of 184.6 ± 20.5s. Doppler ultrasound guided puncture an 93% success rate. Doppler ultrasound guided puncture more than twice the success rate of 100%. Complication rate was 4.64%. Conclusion： Doppler ultrasound guided internal jugular vein in critically ill patients cannulated shortened tube time, reducing the number of puncture and improve the success rate of a puncture.