新生儿锁骨下静脉穿刺置管术的应用解剖

Applied anatomy for newborn subclavian vein puncture

目的 :为新生儿锁骨下静脉穿刺提供应用解剖学基础。方法 :对 15具 30侧新生儿尸体的锁骨下静脉及相关结构进行解剖观测。结果 :锁骨下静脉属支腋静脉与锁骨中线交点距锁骨中点下缘 (6 .2±1.7)mm ;锁骨下静脉与锁骨下缘交点指数为 39.0± 4.5 ,提示交点在锁骨中内 1/3交点稍偏外侧。静脉角位于锁骨上缘距胸锁关节外侧 (10 .0± 2 .4)mm处。上述三点相连 ,即为新生儿锁骨下静脉的体表投影。结论 :沿锁骨下静脉体表投影穿刺进针可获较高的穿刺成功率 ,穿刺应首选右侧 ,穿刺插管长度不超过 5 .8cm(右 )或 4.7cm(左 )。

Objective:To provide anatomical basis for newborn subclavian vein puncture and cannulation.Methods:The subclavian veins and correlative structures were observed and measured in 15 newborn cadavers (30 sides).Results:The intersection of the axillary vein and the midline of clavicle was 6.2±1.7 mm below the midpoint of clavicle.The intersection index was 39.0±4.5.The position of venous angle was 10.0±2.4 mm above the clavicle in the lateral of the sternoclavicular joint.The line connecting this three point was the surface projection of the subclavian vein.Conclusions:Puncture along the surface projection of the subclavian vein will get higher success rate.The right subclavian vein puncture is better than the left,and the length of puncture and cannulation should not be bigger than 5.8 cm(right) or 4.7 cm(left).