不同部位中心静脉置管比较

Comparison study on the central venous catheterization in three different positions for critical patients in ICU

目的研究ICU危重患者三种不同部位中心静脉置管的利弊,分析ICU危重患者适合的中心静脉置管部位。方法分析2年间ICU共160例重症患者通过盲穿方式经锁骨上中心静脉置管、锁骨下中心静脉置管及股静脉置管三种途径中心静脉置管的病例资料,按置管部位不同随机分为3组:1组(锁骨上中心静脉置管),2组(锁骨下中心静脉置管)和3组(股静脉置管),分别观察3组患者在置管成功率、导管留置时间、并发症(感染、气胸、堵塞)等方面的差异,从而探讨ICU危重患者适合的中心静脉置管部位。结果3组患者在置管成功率、导管留置时间及并发症(感染、气胸、堵塞)等方面的差异均无统计学意义(P>0.05)。结论对ICU患者如无特殊需要建议最好选择股静脉置管,如有特殊需要可给予其他部位置管。对于ICU危重患者需根据患者实际情况选择合适的置管部位。

Objective To investigate the advantages and disadvantages of the central venous catheterization in three different positions for critical patients in ICU,and to explore a suitable position of central venous catheterization.Methods The clinical data about 160 critical patients who were treated in Icu in the past two years were retrospectively analyzed,The patients underwent central venous catheterization by blind puncture mode in the three positions,including supraclavicular central venous catheterization,subclavian central venous catheterization and thigh venous catheterization.The patients were randomly divided into three groups according to different positions of central venous catheterization:group 1(supraclavicular central venous catheterization),group 2(subclavian central venous catheterization)and group 3(thigh venous catheterization).The success rate of catheterization,catheter indwelling time,complications(infection,pneumothorax,occlusion)were observed and compared among the three groups.Results There were no significant differences in the success rate of catheterization,catheter indwelling time and complications(infection,pneumothorax,occlusion)among the three groups(P<0.05).Conclusion For the patients in ICU who do not have special needs,it is recommended to choose a thigh venous catheterization.If the patientts have special needs,it iis possibleee to choose the other suitable position of venous catheterization placements according to the actual situation of patient.