经皮穿刺深静脉置管在创伤骨科救治的应用

The actions of central venous catheterization in the treatment of traumatic orthopaedic

目的探讨经皮穿刺深静脉置管在创伤骨科病人救治中的作用。方法对我院ICU1992年 12月至 1999年 12月间采用经皮穿刺深静脉置管法救治的创伤骨科病人 190例的资料进行回顾总结。结果锁骨下静脉穿刺置管 147例 ,股静脉穿刺置管 43例 ,行中心静脉压 (CVP)监测 135例 ,全胃肠外营养 (TPN) 80例 ,总治愈 15 8例 ,死亡 32例。结论深静脉置管具有操作简易、快速、通道可靠的优点。在对伴有严重失血性休克患者的抢救时 ,在CVP监测下进行快速、大量补液治疗 ,以缩短抗休克时间、预防肺水肿的发生 ;对合并有严重腹部脏器损伤和胃肠功能衰竭者 ,尽早进行TPN治疗可提高患者的治愈率。

Objective To evaluate the actions of central venous catheterization (CVC) in the treatment of traumative orthopaedic. Methods 190 cases of CVC with traumatic orthopaetic were studied retrospectively from Dec. 1992 to Dec. 1999. Results Operation was performed in vena subclavia of 147 cases and vena femoralis of 43 cases. Central venous pressure (CVP) was monitored in 135 cases. Total parenteral nutrition (TPN) was 80 cases. 158 patients were cured, 32 died. Conclusion The central venous catheterization was simple and fast operation. It could be short time of antishock and prevent pulmonary edema.