磁铁引导法在锁骨下静脉置管中的临床应用

Use of magnet guidance in the subclavian venous catheterization

目的研究磁铁引导法在锁骨下静脉置管中的效果。方法需行锁骨下静脉置管的患者160例,随机均分为磁铁组和对照组,分别采用磁铁引导(4500Oe)或常规操作对患者实施锁骨下静脉置管,置管后采用X线胸片检查客观评估导管头端位置,探讨导管误入同侧颈内静脉的发生率和置管时主要并发症的发生情况。结果磁铁组有5例(6.25%)误入同侧颈内静脉,明显低于对照组的15例(18.75%)(P<0.05)。两组患者锁骨下静脉穿刺置管的一次成功率、置管时间和穿刺置管时的主要并发症差异无统计学意义。结论磁铁引导法可显著降低锁骨下静脉置管过程中导管误入同侧颈内静脉的机率。

Objective To evaluate the efficacy of a magnet guidance technique in reduction of internal jugular misplacement during subclavian venous catheterization （SVC）. Methods A total of 160 patients were enrolled into the prospective randomized control study and were randomly selected into either magnet guided group （n： 80,4500 Oe） or control group （n： 80）. All patients received SVC placement. Chest X-ray was used following placement to evaluate the placement of the central venous catheter to discuss the incidence of catheter to ipsilateral internal jugular vein. Results The incidence of ipsilatera internal jugular misplacement in the magnet guided group was 6.25 % compared to 18. 75% in the control group （P〈0.05）. There was no difference with the successful rate, complications and operation time. Conclusion Magnet guidance technique can be useful in reduction of ipsilateral jugular misplacement during SVC.