超声引导在先天性心脏病婴幼儿颈内静脉穿刺置管术中的应用

The application of ultrasound guided catheterization of the internal jugular vein in infants of congenital heart disease

目的探讨超声引导下行婴幼儿先天性心脏病颈内静脉穿刺置管术的应用价值。方法随机抽取择期先天性心脏病手术的婴幼儿66例,随机分为传统方法组(A组)和超声引导组(B组),每组33例。记录并比较两组的一次性穿刺置管成功时间、总成功率、穿刺失败和导丝置入失败例数。测量两组穿刺置管成功后穿刺点(导管)与颈内动脉间距,并比较它们在两组间的差异。结果 B组一次性穿刺成功率、总穿刺成功率均高于A组(P<0.05),穿刺点距离颈内动脉也明显大于A组(P<0.05),并且穿刺并发症明显低于A组。结论超声引导下先天性心脏病婴幼儿颈内静脉穿刺置管较传统定位方法准确,具有成功率高、更安全、并发症低的特点,有很高的临床应用价值。

Objective To explore the value of ultrasoundguided catheterization of the internal jugular vein in infants of congenital heart disease. Methods 66 infants who were selective operation for congenital heart diseases were randomly divid ed into A group （catheterization by traditional method,n=33） and B group （catheterization guided by ultrasonography, n=33）. The success rate of catheterization at first attempt, the overall success rate of catheterization, puncture failure and failure cases of guide wire insertion during catheterization in two groups were recorded and compared. Results The total success rate of catheterization and the success rate of catheterization at first attempt in B group were significantly higher than those in A group, and the distance between puncture point and internal carotid artery in B group was rarer than in A group （P〈0.05）. The punc ture complications in B group was also lower than in the A group. Conclusion The right internal jugular vein catheterization guided by ultrasound in infant patients with congenital heart diseases was more high success and secure rate, and low complica tion than traditional way.So it has very high value in clinical application.