两种锁骨下静脉穿刺术的穿刺成功率与安全性比较

Comparison between the puncture success rate and safety of two subclavian venipuncture methods

目的比较常规锁骨下静脉穿刺与改进二点法锁骨下静脉穿刺的穿刺成功率及安全性。方法将本院220例行锁骨下静脉穿刺患者随机分为常规组80例和二点组140例,常规组患者进行常规锁骨下静脉穿刺,二点组患者进行改进二点法锁骨下静脉穿刺,比较2组患者的穿刺成功率及穿刺置管相关并发症的发生情况。结果二点组患者穿刺置管成功率显著高于常规组,差异有统计学意义;二点组误伤动脉、血气胸及空气栓塞等并发症发生率有低于常规组的趋势,但差异无统计学意义。结论改进二点法锁骨下静脉穿刺能显著提高穿刺成功率,减少并发症的发生,值得临床推广。

Objective To compare the puncture success rate and safety of routine subclavian venipuncture with modified two-point-method subclavian venipuncture.Methods Two hundred and twenty patients receiving subclavian venipuncture in our hospital were randomly divided into routine group （n =80） and two-point group （n =140）.The patients in routine group were given routine subclavian venipuncture,while those in two-point group given modified two-point-method subclavian venipuncture.The puncture success rates and incidences of catheterization-induced complications of patients were compared between both groups.Results The puncture success rate of patients in two-point group was significantly higher than that in routine group,and the difference had statistical significance; the incidences of complications like arterial injury,hemopneumothorax and aeroembolism had the tendency of lowering those in routine group,but the difference showed no statistical significance.Conclusion Modified two-point-method subclavian venipuncture can significantly improve the puncture success rate and decrease the incidence of complications,so it deserves to be popularized in clinical practice.