超声定位在婴幼儿颈内静脉穿刺置管中的应用

The application of ultrasound localization in internal jugular vein catheterization in infants

目的探讨超声定位在婴幼儿颈内静脉穿刺置管中的应用效果。方法选择1月～1岁的先天性心脏病择期手术患儿60例,随机均分为两组:超声定位组(D组)使用便携式B超仪在颈部以二维超声图像确定颈内静脉位置进行穿刺;对照组(C组)以锁骨内侧端上缘切迹作为骨性标志进行穿刺。记录一次穿刺成功率、穿刺次数、穿刺时间和并发症发生率。结果 D组一次穿刺成功率明显高于C组(93%vs.67%,P<0.01),穿刺次数和操作时间明显少于C组(P<0.05),误穿颈动脉率明显低于C组(P<0.05)。结论婴幼儿颈内静脉穿刺置管应用超声定位准确,一次穿刺成功率高,并发症发生率低,穿刺时间短,安全可靠。

Objective To explore the effect of ultrasound localization on internal jugular vein catheterization in infants. Methods Sixty infants, aged 1-12 months, with congenital heart disease undergoing selective operation, were randomly divided into two groups, ultrasound localization group （group D）： two dimensional ultrasound image was used to determine the position of the internal jugular vein; control group （group C）.. medial clavicular notch were regarded as a marker. The successful puncture rate at first try, total puncture times and complications were recorded. Results The success rate at first puncture in group D was higher than group C （93% vs. 67%,P〈 0. 01）, Total duration and times of puncture was significantly less than group C （P〈0.05）. Complication such as carotid artery puncture was lower than group C （P〈0. 05）. Conclusion The application of ultrasound localization in internal jugular vein puncture in infants is a high accuracy method with less operating duration, more successful rate and lower complication.