锁骨下静脉穿刺心脏介入通路的解剖学基础

Anatomical bases of percutaneous puncture of subclavian vein for approaching the heart

目的 :为锁骨下静脉穿刺的心脏介入通路提供解剖学依据。方法 :采用 35具成人尸体、4套成人躯干连续横断层和1套连续矢状断层标本 ,观测相关参数。结果 :锁骨下静脉、头臂静脉和上腔静脉的长度与外径值 ,与其它路径相比 ,右侧锁骨上经皮锁骨下静脉穿刺的介入通路具有路径短、弯曲小的优点。穿刺点选在锁骨上缘中、内 1/ 3交界处的上方 ,针尖指向胸锁关节稍外侧。结论 :首选右侧锁骨上经皮锁骨下静脉穿刺的心脏介入通路。

?Objective:To provide anatomical bases for percutaneous puncture of subclavian vein for approaching the heart.Methods:The distance and external diameter of subclavian vein,brachiocephalic vein and superior vena cave were obtained from 35 adult cadavers,1 set of serial sagittal and 4 sets of serial transverse sections of trunk of adult cadavers.Results:In comparison with other approaches,the right supraclavian approach for percutaneous subclavian vein puncture had the characters of short distance and little curve.The needle should be pointed toward the sternoclavicular joint from the junction of the medial and middle thirds above the clavicle.Conclusions:It shows that the percutaneous puncture of subclavian vein should be performed on the right side through the supraclavian approach.