锁骨中点定位腋静脉置管到位率的研究

Study on the placement rate of axillary vein in the position of the midpoint of the clavicle

目的探讨锁骨中点定位腋静脉穿刺方法的临床应用。方法选择需行中心静脉置管术患者100例随机分为2组,试验组50例采用超声测量引导法,对照组50例采用传统盲穿法。观察2组穿刺操作时间、穿刺次数、穿刺成功率、置管到位率及并发症。结果试验组操作时间较对照组短(P<0.01),穿刺置管深度较对照组深(P<0.01),一次穿刺成功率较对照组高(P<0.05),2组置管到位率差异无统计学意义(P>0.05)。2组均无误伤动脉、气胸、穿刺部位异常出血、导管堵塞等并发症。2组住院期间穿刺部位无1例发生感染。结论应用彩色多普勒超声引导经腋静脉中心静脉置管术成功率和到位率高,并发症少,住院期间穿刺部位感染发生率低,安全可靠,且操作时间少,适于临床推广应用。

Objective To investigate the clinical application of the method of puncture of the axillary vein in the position of the clavicle. Methods One hundred patients with central venous catheterization were randomly divided into 2 groups. In the control group,50 cases were treated by traditional blind method. puncture operation time,the number of puncture,Puncture success rate,catheter placement rate and complications in 2 groups were observed. Results he operation time of the experimental group was less than that of the control group（ P〈0. 01）. The depth of the catheterization in the experimental group was deeper than that in the control group（ P〈0. 01）. The successful rate of one time puncture was higher than that of the control group（ P〈0. 05）. There was no significant difference in the rate of inbution in both groups（ P〈0. 05）. There were no injury of arterial puncture,pneumothorax,catheter obstruction,abnormal bleeding of puncture site and other complications. There was no infection in the puncture site during the period of hospitalization in two groups. Conclusion Application of color Doppler ultrasound guided by axillary vein central venous catheter operation has high success rate,high in place rate,fewer complications,low incidence of infection during hospitalization. This method is safe and reliable. The operation time is less and is suitable for clinical promotion.