CT三维重建技术应用于中心静脉置管的研究

RESEARCH ON USING CT THREE-DIMENSIONAL RECONSTRUCTION IN CENTRAL VENOUS CATHERIZATION

目的探讨CT三维重建技术应用于右颈内静脉穿刺中心静脉置管的可行性。方法选择需要中心静脉穿刺的择期手术患者106例,随机分为两组。A组43例,在三维重建技术应用于中心静脉置管术;B组63例,在体表定位后行右颈内静脉穿刺置管测压术。分别记录穿刺成功次数、穿刺操作的总时间、穿刺后的并发症等。结果 A组一次穿刺成功5例,二次穿刺成功9例,三次穿刺成功21例,四次穿刺成功6例,5次穿刺成功3例;穿刺操作总时间平均(29.1±7.8)min,并发症7例。B组一次穿刺成功59例,二次穿刺成功3例,三次穿刺成功1例,穿刺操作总时间平均(10.5±7.6)min,无并发症发生。两组比较,B组明显优于A组(P<0.05)。结论 CT三维重建技术应用于右颈内静脉穿刺置管中心静脉可提高成人颈内静脉穿刺的成功率和安全性。

Objective To explore the feasibility of using CT three-dimensional reconstruction in central venous catherization of right internal jugular venipuncture.Methods 106 patients needing central venous catherization were randomly divided into Group A of 43 patients receiving three-dimensional reconstruction in central venous catherization and Group B of 63 patients receiving right internal jugular venipuncture after surface location.The success rate,the total time of puncture and the complications after punctures were recorded.Results In Group A,successful one–attempt puncture occurred in 5cases,successful second-attempt puncture in 9cases and successful third-attempt puncture in 21 cases,successful fourth-attempt puncture in 6cases and successful fifth-attempt puncture in 3cases.The average total time was（29.1±7.8）minutes,and complications occurred in 7cases.In Group B,successful one–attempt puncture occurred in 59 cases,successful second-attempt puncture in 3cases and successful third-attempt puncture in 1case.The average total time was（10.5±7.6）minutes,and no complications occurred.There existed significant difference between the two groups（P〈 0.05）.Conclusion CT three-dimensional reconstruction in central venous catherization of right internal jugular venipuncture can significantly improve the success rate and safety of adult internal jugular venipuncture.