超声引导下颈内静脉穿刺置管术在危重患者中的应用价值

Application value of ultrasound-guided internal jugular vein puncture catheterization in treatment of critical patients

目的探讨超声引导下颈内静脉穿刺置管术在基层医院危重患者中的临床应用价值。方法选取入住重症医学科需行颈内静脉穿刺置管术的危重患者200例,随机分为应用超声引导下颈内静脉穿刺置管的超声组和应用体表解剖标志定位进行颈内静脉穿刺置管的传统组,每组100例。比较2组从进针至置管完成的穿刺时间、穿刺次数、成功率、并发症的发生情况。结果超声组平均操作时间明显低于传统组(P<0.05);超声组平均穿刺次数明显少于传统组(P<0.01);超声组穿刺成功率高于传统组,2组比较差异有统计学意义(P<0.05)。并发症的发生率超声组明显降低,2组比较差异有统计学意义(P<0.05)。结论超声引导下颈内静脉穿刺置管术成功率高,缩短了穿刺时间,减少了穿刺次数,降低了不良反应,且操作简单,易于掌握,适合在基层医院广泛开展。

Objective To explore the application value of ultrasound-guided internal jugular vein puncture catheterization in treating critical patients. Methods A total of 200 critical patients who had to receive internal jugular vein puncture catheterization were randomly divided into ultrasound group（ n = 100）,in which,the operation was performed by ultrasound-guided internal jugular vein puncture catheterization,and traditional surgery group（ n = 100）,in which,the operation was carried out by anatomic landmark localization. The puncture time（ from inserting needle to tube placement）,frequency of puncture,success rates and incidence rate of complications were observed and compared between two groups.Results The average duration of operation in ultrasound group was significantly shorter than that in traditional surgery group（ P 〈0. 05）. And the average number of puncture in ultrasound group was significantly less than that in traditional surgery group（ P〈 0. 05）. In addition,the success rate of puncture in ultrasound group（ 100%） was significantly higher than that（ 92%） in traditional surgery group（ P〈 0. 05）. Moreover,the incidence rate of complications in ultrasound group was significantly lower than that in traditional surgery group（ P 〈0. 05）. Conclusion Ultrasound-guided internal jugular vein puncture catheterization has higher success rate,which can shorten puncture time,reduce the frequency of puncture and incidence rate of complications,moreover,it is simple and easy to master,thus,which is available in primary hospital.