18G套管针应用于成人颈内静脉穿刺术的可行性研究

Feasibility of 18G trocar applied in jugular vein puncture for adults

目的探讨18G套管针用于成人中心静脉穿刺置管术的可行性。方法回顾性分析2017年4月至8月在局部麻醉下进行中心静脉置管术的60例患者的临床资料。将60例患者随机分为对照组和观察组,穿刺置管部位选择颈内静脉,对照组采用常规穿刺针进行穿刺置管,观察组采用18G套管针替代常规穿刺针进行穿刺置管。结果 2组患者穿刺置管成功率比较差异无统计学意义(P>0.05);与对照组相比,观察组的一次置导丝成功率较高,穿刺时间明显缩短,在穿刺操作期间疼痛评分较低,术后患者满意度较高,2组比较差异均具有统计学意义(P<0.05)。结论 18G套管针能够很好地完成中心静脉穿刺置管,在清醒患者中该方法具有很大的优势,部分导丝置入困难的患者也可以采用。

Objective To investigate the feasibility of 18G trocar for central venous catheterization in adults. Methods Retrospective analyzed the clinical data of 60 patients with central venous catheterization under local anesthesia. These patients were randomly divided into the control group and the observation group. Selected the internal jugular vein as the site of the puncture catheter. The control group was punctured by conventional puncture needle while the observation group was punctured by the 18G trocar. Results There was no statistical difference between the two groups in the success rate of final puncture and catheterization （P 〉 0.05 ）. Compared with the control group, the success rate of guidewire insert was higher,the puncture operation time was shorter, the pain score during puncture operation was lower, and postoperative patient satisfaction was higher in the observation group. The differences of the two groups were statistically significant （ P 〈 0.05 ）. Conclusion 18G trocar can perform central venous catheterization successfully. This method has great advantages for awake patients,and it also worked in some cases with difficult wire insertion.