实时超声引导下不同部位中心静脉的穿刺置管效果及并发症比较

Comparison of the effect and complications of central venous catheterization in different sites under real-time ultrasound guidance

目的:探讨实时超声引导下不同部位中心静脉(CV)的穿刺置管效果及并发症。方法:104例拟接受实时超声引导下CV置管术的住院患者分成锁骨下静脉(SCV)组和颈内静脉(IJV)组,每组各52例。比较两组患者穿刺操作时间、穿刺成功率和并发症发生情况。结果:两组患者超声引导下穿刺置管成功率均为100%,但IJV组首次穿刺成功率(92.31%)高于SCV组(76.92%),且用时短于SCV组,差异有统计学意义(P<0.05)。两组患者均未出现气栓、气胸等严重并发症,且出现误入动脉、局部血肿、局部感染等并发症的发生率比较,差异无统计学意义(P>0.05)。结论:实时超声引导下SCV和IJV的穿刺置管效果均较好,但IJV的首次穿刺成功率高,用时短,临床可结合操作者经验水平和患者个体情况等酌情选择穿刺路径。

Objective:To investigate the effect and complications of puncture and catheterization of central vein(CV)in different parts under the guidance of real-time ultrasound.Methods:104 hospitalized patients undergoing real-time ultrasound-guided CV catheterization were randomly divided into subclavian vein(SCV)group and internal jugular vein(IJV)group,52 cases in each group.The operation time,puncture success rate and complications were compared between the two groups.Results:The success rate of ultrasound-guided catheterization was 100%in both groups.The first puncture success rate of IJV group was 92.31%,which was higher than that of SCV group(76.92%).The time of successful puncture and catheterization in IJV group was shorter than that in SCV group(P<0.05).There were no serious complications such as air embolism and pneumothorax between the two groups.There was no significant difference in the incidences of entering artery,local hematoma,local infection and total complications between the two groups(P>0.05).Conclusion:Both SCV and IJV under the guidance of real-time ultrasound have good puncture effect,but the first puncture success rate of IJV is high and the time is short.The puncture path can be selected according to the experience of the operator and the individual condition of the patient.